Individual provider Active NPI

Tracy A Homan, DC

  • Chiropractor
  • Cincinnati, OH
National Provider Identifier
1043254279
Registry record updated Nov 10, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
03544 Issued in OH
Practice address
4380 Gleneste Withamsville Rd
Cincinnati, OH 45245-1523
Phone
(513) 753-6325
Fax
(513) 753-6320
NPI assigned
Jun 16, 2006
Last updated
Nov 10, 2021By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 10, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 5162 KY
Chiropractor 111N00000X 03544 OH Primary

Addresses

Primary practice location

4380 Gleneste Withamsville Rd
Cincinnati, OH 45245-1523

Mailing address

4380 Gleneste Withamsville Rd
Cincinnati, OH 45245-1523
Phone (513) 753-6325

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050504000073 OH Practitioner - Chiropractic 5890735468 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Cleveland Chiropractic College - Kansas City, 2001
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

4380 Glen Este Withamsville Rd
Cincinnati, OH 45245-1523
Phone (513) 753-6325

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
03544OHMDOccupational Therapy Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
McConkey Chiropractic, LLC Chiropractor PastSince Oct 20, 2024 Accepting new patients
Chiropractic Care Center Chiropractor PastSince Oct 1, 2024 Accepting new patients

Organizations & group practices 3

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

NPI Registry JSON

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

{
    "created_epoch": "1150416000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1636502400000",
    "number": "1043254279",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4380 GLENESTE WITHAMSVILLE RD",
            "city": "CINCINNATI",
            "state": "OH",
            "postal_code": "452451523",
            "telephone_number": "513-753-6325",
            "fax_number": "513-753-6320"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4380 GLENESTE WITHAMSVILLE RD",
            "city": "CINCINNATI",
            "state": "OH",
            "postal_code": "452451523",
            "telephone_number": "513-753-6325",
            "fax_number": "513-753-6320"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HOMAN",
        "first_name": "TRACY",
        "middle_name": "A",
        "name_prefix": "Dr.",
        "credential": "DC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-06-16",
        "last_updated": "2021-11-10",
        "certification_date": "2021-11-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "KY",
            "license": "5162",
            "primary": false
        },
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "OH",
            "license": "03544",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cincinnati, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 10, 2021; 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.