MS. STEPHANIE GORDON (CNM) – Advanced Practice Midwife, NPI 1174992127

MS. STEPHANIE GORDON (CNM) is a healthcare provider. based in Urbana, Illinois. specializing in CERTIFIED NURSE MIDWIFE (CNM). They hold the professional credentials CNM. They hold a License No. 209.013249 (IL). The NPI Number for MS. STEPHANIE GORDON (CNM) is 1174992127

Main info

Female
11 Years Of Experience
Accepts Medicare Assignment
Name
MS. STEPHANIE GORDON (CNM)
NPI
1174992127
Phone
(217) 383-3311
Address
611 W PARK ST
Enumeration Date
21 September 2015
Last Update Date
15 April 2025

Doctor Profile

Medical School Name
UNIVERSITY OF CINCINNATI COLLEGE OF MEDICINE
Secondary Phone
2173423337
Graduation Year
2015 (11 years ago)
PAC ID
5395053557
Group Practice PAC ID
2961726021
Professional Enrollment ID
I20151007003133
Address ID
IL624011788EF912XXSTXX400
Data current as of
20 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience44
Completeness75
Years active:10State licenses:1Digital endpointsOther names

237 CERTIFIED NURSE MIDWIFE (CNM) in IL

Provider Addresses for MS. STEPHANIE GORDON (CNM)

  • 611 W PARK ST

    URBANA, IL 618012529

    Phone: (217) 383-3311

    Type: Location

  • 611 W Park St

    Urbana, IL 618012529

    Phone: (217) 383-3311

    Type: Location

  • 3408 Office Park Dr

    Marion, IL 629596477

    Phone: (618) 997-5266

    Fax: (618) 997-5285

    Type: Location

  • 611 W. PARK ST

    FAPC

    URBANA, IL 61801

    Phone:

    Type: Mailing

  • 912 N HENRIETTA ST

    EFFINGHAM, IL 624011788

    Phone: (217) 342-3337

    Fax: (217) 347-3328

    Type: Location

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2015-10-07

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20151007003133ICertified Nurse Midwife (Cnm)ILTBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 61801)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 2961726021View full group profile
NameSpecialtyState
-IL
Certified Nurse Midwife (Cnm)IL
O B S T E T R I C S/ G Y N E C O L O G YIL
O B S T E T R I C S/ G Y N E C O L O G YIL
Physician AssistantIL
Nurse PractitionerIL
O B S T E T R I C S/ G Y N E C O L O G YIL
Physician AssistantIL
O B S T E T R I C S/ G Y N E C O L O G YIL
O B S T E T R I C S/ G Y N E C O L O G YIL

Reviews

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Frequently asked questions

Can I use this page to confirm MS. STEPHANIE GORDON (CNM)'s NPI?
Yes. MS. STEPHANIE GORDON (CNM) is listed with NPI 1174992127 in the public NPI dataset.
Can I rely on MS. STEPHANIE GORDON (CNM) being an active provider?
As of the registry snapshot, MS. STEPHANIE GORDON (CNM) is marked active.
What is MS. STEPHANIE GORDON (CNM)'s primary classification?
Advanced Practice Midwife is the headline specialty for MS. STEPHANIE GORDON (CNM) here. Clinical services aligned with this taxonomy classification.
Where is MS. STEPHANIE GORDON (CNM) based?
MS. STEPHANIE GORDON (CNM) is tied to Urbana, Illinois in the data we show; additional addresses may exist on the full record.
What does 'Individual Provider' mean on this profile?
Entity type tells you whether the number belongs to a person or an organization.

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