Stacey Alicia Vandyke, CRNA

Primary specialty

Certified Registered Nurse AnesthetistTaxonomy code 367500000X

License

9342364 Issued in FL

Practice address

4102 Pinion Dr
Usaf Academy, CO 80840-2502

Phone

(719) 333-5651

NPI assigned

Jan 12, 2007

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Other names 1

• Stacey Alicia Goss Former name

Medicare fee-for-service enrollment

Enrolled in FL

Enrollment records 1

Specialty

Certified Registered Nurse Anesthetist (Crna)

Education

Other, 2006

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Jackson Anesthesia Associates IncGroup PAC ID 0749273282, 16 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Not enrolled

HHS exclusion list flag

Flagged The directory lists this NPI on an HHS exclusion list. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.

Credentials

Certified Registered Nurse

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Jackson Anesthesia Associates Inc

  • Certified Registered Nurse Anesthetist
  • Marianna, FL
  • NPI 1033168612

  Nurse Anesthetist, Certified Registered

  Medicare reassignment Care Compare group NPD
• Anesthesia Dynamics LLC

  • Anesthesiology Physician
  • Bradenton, FL
  • NPI 1073001012

  Nurse Anesthetist, Certified Registered

  Medicare reassignment NPD
• US Anesthesia Partners of Florida Inc.

  • Anesthesiology Physician
  • Maitland, FL
  • NPI 1518910520

  Nurse Anesthetist, Certified Registered

  Medicare reassignment NPD

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1168560000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1365379200000",
    "number": "1841340544",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "311 MOONLIGHT BAY DR",
            "city": "PANAMA CITY BEACH",
            "state": "FL",
            "postal_code": "324072818",
            "telephone_number": "205-306-5745"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4102 PINION DR",
            "city": "USAF ACADEMY",
            "state": "CO",
            "postal_code": "808402502",
            "telephone_number": "719-333-5651"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VANDYKE",
        "first_name": "STACEY",
        "middle_name": "ALICIA",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-01-12",
        "last_updated": "2013-04-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "CA",
            "license": "530337",
            "primary": false
        },
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "FL",
            "license": "9342364",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "STACEY",
            "last_name": "GOSS",
            "middle_name": "ALICIA",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Eliseo Alexander Torres, DO
• Henry Allen Touchton, D.D.S
• Kim D Tran
• Linh Thuy Truong, DMD
• Usafa
• Bethany Vawter
• Jamie Virden, PHYSICIAN ASSISTANT
• Derek Vraa, PT
• John Wesley Waggoner, PSY.D.
• Mary Claire Wahl, C.N.M.

• Certified Registered Nurse Anesthetist in Usaf Academy, CO
• Providers in Usaf Academy, CO by specialty
• Certified Registered Nurse Anesthetist in Colorado

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 8, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.