Active NPI
Teresa Tracy, M.D.
- Child & Adolescent Psychiatry Physician
- Goldsboro, NC
National Provider Identifier
1073067492
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Child & Adolescent Psychiatry Physician
- License
- 109103
- Practice address
- 817 Mill Rd
Goldsboro, NC 27534-8947 - Phone
- (913) 980-5370
- NPI assigned
- Aug 15, 2016
- Sex
- Female
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Child & Adolescent Psychiatry Physician | 2084P0804X | 109103 | MO | Primary |
Addresses
Primary practice location
817 Mill Rd
Goldsboro, NC 27534-8947
Mailing address
817 Mill Rd
Goldsboro, NC 27534-8947
Phone (913) 980-5370
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
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 109103 | MO | MD | Child & Adolescent Psychiatry Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1471219200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1471219200000",
"number": "1073067492",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "817 MILL RD",
"city": "GOLDSBORO",
"state": "NC",
"postal_code": "275348947",
"telephone_number": "913-980-5370"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "817 MILL RD",
"city": "GOLDSBORO",
"state": "NC",
"postal_code": "275348947",
"telephone_number": "913-980-5370"
}
],
"practiceLocations": [],
"basic": {
"last_name": "TRACY",
"first_name": "TERESA",
"credential": "M.D.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2016-08-15",
"last_updated": "2016-08-15",
"status": "A"
},
"taxonomies": [
{
"code": "2084P0804X",
"taxonomy_group": "",
"desc": "Psychiatry & Neurology, Child & Adolescent Psychiatry",
"state": "MO",
"license": "109103",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Goldsboro, NC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 15, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.