Tracy Iranshahr, TRACY

Primary specialty

Speech-Language AssistantTaxonomy code 2355S0801X

License

SLPA10666 Issued in AZ

Practice address

2745 N Black Rock Rd
Buckeye, AZ 85396-1813

Phone

(623) 537-7224

NPI assigned

Nov 22, 2017

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Mrs. Tracy Iranshahr Professional name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1511308800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1511308800000",
    "number": "1003320334",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2745 N BLACK ROCK RD",
            "city": "BUCKEYE",
            "state": "AZ",
            "postal_code": "853961813"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2745 N BLACK ROCK RD",
            "city": "BUCKEYE",
            "state": "AZ",
            "postal_code": "853961813",
            "telephone_number": "623-537-7224"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "IRANSHAHR",
        "first_name": "TRACY",
        "name_prefix": "Mrs.",
        "credential": "TRACY",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-11-22",
        "last_updated": "2017-11-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2355S0801X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Speech-Language Assistant",
            "state": "AZ",
            "license": "SLPA10666",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DRIVERS LICENSE",
            "identifier": "D04163830",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "TRACY",
            "last_name": "IRANSHAHR",
            "prefix": "MRS.",
            "credential": "SPLA",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

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• Speech-Language Assistant in Buckeye, AZ
• Providers in Buckeye, AZ by specialty
• Speech-Language Assistant in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 22, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.