Active NPI
Tracie Lee Beckmann
- Speech-Language Pathologist
- O Fallon, MO
National Provider Identifier
1083215768
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Speech-Language Pathologist
- License
- 26793
- Practice address
- 731 Falcon Hill TRL
O Fallon, MO 63368-8194 - Phone
- (636) 448-0995
- NPI assigned
- Nov 8, 2020
- 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 |
|---|---|---|---|---|
| Speech-Language Pathologist | 235Z00000X | 26793 | NV | Primary |
Addresses
Primary practice location
731 Falcon Hill TRL
O Fallon, MO 63368-8194
Mailing address
731 Falcon Hill TRL
O Fallon, MO 63368-8194
Phone (636) 448-0995
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 26793 | NV | MD | Speech-Language Pathologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1604793600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1604793600000",
"number": "1083215768",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "731 FALCON HILL TRL",
"city": "O FALLON",
"state": "MO",
"postal_code": "633688194",
"telephone_number": "636-448-0995"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "731 FALCON HILL TRL",
"city": "O FALLON",
"state": "MO",
"postal_code": "633688194",
"telephone_number": "636-448-0995"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BECKMANN",
"first_name": "TRACIE",
"middle_name": "LEE",
"name_prefix": "Mrs.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2020-11-08",
"last_updated": "2020-11-08",
"certification_date": "2020-11-08",
"status": "A"
},
"taxonomies": [
{
"code": "235Z00000X",
"taxonomy_group": "",
"desc": "Speech-Language Pathologist",
"state": "NV",
"license": "26793",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in O Fallon, MO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 8, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.