Active NPI
Tracy Vanburen, MS
- Psychologist
- Charlotte, NC
National Provider Identifier
1063637163
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychologist
- License
- NC2299
- Practice address
- 8520 Cliff Cameron Drive
Suite 460 Excel Personel Development
Charlotte, NC 28269 - Phone
- (704) 510-1535
- Fax
- (704) 940-8060
- NPI assigned
- Apr 16, 2007
- 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 |
|---|---|---|---|---|
| Psychologist | 103T00000X | NC2299 | NC | Primary |
Addresses
Primary practice location
8520 Cliff Cameron Drive
Suite 460 Excel Personel Development
Charlotte, NC 28269
Mailing address
8427 Appledale Drive
Charlotte, NC 28262
Phone (704) 649-5063
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)
- Not enrolled
- Credentials
- Master of Science
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| NC2299 | NC | MD | Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1176681600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1063637163",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "8427 APPLEDALE DRIVE",
"city": "CHARLOTTE",
"state": "NC",
"postal_code": "28262",
"telephone_number": "704-649-5063"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "8520 CLIFF CAMERON DRIVE",
"address_2": "SUITE 460 EXCEL PERSONEL DEVELOPMENT",
"city": "CHARLOTTE",
"state": "NC",
"postal_code": "28269",
"telephone_number": "704-510-1535",
"fax_number": "704-940-8060"
}
],
"practiceLocations": [],
"basic": {
"last_name": "VANBUREN",
"first_name": "TRACY",
"name_prefix": "Ms.",
"credential": "MS",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-04-16",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "103T00000X",
"taxonomy_group": "",
"desc": "Psychologist",
"state": "NC",
"license": "NC2299",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Charlotte, NC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.