Individual provider Active NPI

Tracy Lynn Waddington, DC

  • Chiropractor
  • Omaha, NE
National Provider Identifier
1093798381
Registry record updated Jun 18, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
1128 Issued in NE
Practice address
2085 N 120TH St Ste D10
Omaha, NE 68164-3480
Phone
(402) 397-3339
Fax
(402) 399-9271
NPI assigned
Nov 21, 2005
Last updated
Jun 18, 2021By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 18, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 1128 NE Primary

Addresses

Primary practice location

2085 N 120TH St Ste D10
Omaha, NE 68164-3480

Mailing address

2085 N 120TH St Ste D10
Omaha, NE 68164-3480
Phone (402) 397-3339

Other identifiers 2

IdentifierTypeStateIssuer
91184385200MedicaidNE
350039494OtherNEPALMETTO GBA

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100927001217 NE Practitioner - Chiropractic 3476655689 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Palmer College Chiropractic - Davenport, 1994
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

2085 N 120TH St
Suite D10
Omaha, NE 68164-3480
Phone (402) 397-3339

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
1128NEMDMental Health Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Back to Back Chiropractic, LLC Chiropractor CurrentSince Oct 6, 2024 Accepting new patients
Waddington Chiropractic LLC Chiropractor CurrentSince Jul 1, 2015 Accepting new patients

Locations

2085 N 120th St
Ste D10
Omaha, NE 68164
Phone (402) 397-3339

2506 N 72nd St
Omaha, NE 68134
Phone (402) 350-3618

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": "1132531200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1623974400000",
    "number": "1093798381",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2085 N 120TH ST STE D10",
            "city": "OMAHA",
            "state": "NE",
            "postal_code": "681643480",
            "telephone_number": "402-397-3339",
            "fax_number": "402-399-9271"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2085 N 120TH ST STE D10",
            "city": "OMAHA",
            "state": "NE",
            "postal_code": "681643480",
            "telephone_number": "402-397-3339",
            "fax_number": "402-399-9271"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WADDINGTON",
        "first_name": "TRACY",
        "middle_name": "LYNN",
        "name_prefix": "Dr.",
        "credential": "DC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-11-21",
        "last_updated": "2021-06-18",
        "certification_date": "2021-06-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "NE",
            "license": "1128",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "91184385200",
            "state": "NE"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PALMETTO GBA",
            "identifier": "350039494",
            "state": "NE"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Omaha, NE

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 18, 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.