Active NPI
Tracy Blood, PH.D
- Clinical Psychologist
- Silver Spring, MD
National Provider Identifier
1013280015
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- 04991
- Practice address
- 11120 New Hampshire Ave
Suite # 204
Silver Spring, MD 20904-2633 - Phone
- (301) 593-1315
- Fax
- (301) 681-4699
- NPI assigned
- Feb 22, 2012
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Psychologist | 103TC0700X | 04991 | MD | Primary |
Addresses
Primary practice location
11120 New Hampshire Ave
Suite # 204
Silver Spring, MD 20904-2633
Mailing address
11120 New Hampshire Ave
Suite # 204
Silver Spring, MD 20904
Phone (301) 593-1315
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 12329271 | Other | MD | CAQH |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Philosophy
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1329868800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1329868800000",
"number": "1013280015",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "11120 NEW HAMPSHIRE AVE",
"address_2": "SUITE # 204",
"city": "SILVER SPRING",
"state": "MD",
"postal_code": "20904",
"telephone_number": "301-593-1315",
"fax_number": "301-681-4699"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "11120 NEW HAMPSHIRE AVE",
"address_2": "SUITE # 204",
"city": "SILVER SPRING",
"state": "MD",
"postal_code": "209042633",
"telephone_number": "301-593-1315",
"fax_number": "301-681-4699"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BLOOD",
"first_name": "TRACY",
"credential": "PH.D",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2012-02-22",
"last_updated": "2012-02-22",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "MD",
"license": "04991",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "CAQH",
"identifier": "12329271",
"state": "MD"
}
],
"endpoints": [],
"other_names": []
}Other providers in Silver Spring, MD
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 22, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.