Tracey Goodman Skale, M.D.

Primary specialty

Psychiatry PhysicianTaxonomy code 2084P0800X

License

35-06-2674 Issued in OH

Practice address

2621 Victory Pkwy
Cincinnati, OH 45206-1754

Phone

(513) 861-6688

Fax

(513) 559-3848

NPI assigned

Jul 27, 2006

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 2

Other names 1

• Dr. Tracey Goodman Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

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

{
    "created_epoch": "1153958400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1678147200000",
    "number": "1003830647",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4965 TAFT PL",
            "city": "CINCINNATI",
            "state": "OH",
            "postal_code": "452433961",
            "telephone_number": "513-658-0012"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2621 VICTORY PKWY",
            "city": "CINCINNATI",
            "state": "OH",
            "postal_code": "452061754",
            "telephone_number": "513-861-6688",
            "fax_number": "513-559-3848"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SKALE",
        "first_name": "TRACEY",
        "middle_name": "GOODMAN",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-07-27",
        "last_updated": "2023-03-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "OH",
            "license": "35-06-2674",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANRHEM PROVIDER",
            "identifier": "000000316132",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0997088",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "TRACEY",
            "last_name": "GOODMAN",
            "prefix": "DR.",
            "credential": "M.D.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Sjo Kids Inc
• Sjo Kids Inc
• Matthew David Sjoblom, M.D.
• Marsha Joann Skaggs, MA, LSW, PCC
• Brian T. Skale, M.D.
• Stephanie Skavdahl, LISW-S
• Abigail Lauren Skeens
• Holly Skeens
• Alanna Skelly, LPN
• Rose Margaret Skelly

• Psychiatry Physician in Cincinnati, OH
• Providers in Cincinnati, OH by specialty
• Psychiatry Physician in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 2023; 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.