Tracey Renee Dumphy

Primary specialty

Occupational TherapistTaxonomy code 225X00000X

License

OT 13317 Issued in FL

Practice address

1024 Florida Ave S
Ste. 6
Rockledge, FL 32955-2152

Phone

(321) 634-3688

Fax

(321) 504-0955

NPI assigned

Sep 23, 2008

Sex

Female

Sole proprietor

Yes

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Sep 23, 2008.

{
    "created_epoch": "1222128000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1222128000000",
    "number": "1104076587",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "127 RIDGEMONT CIR SE",
            "city": "PALM BAY",
            "state": "FL",
            "postal_code": "329092318",
            "telephone_number": "321-327-4919"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1024 FLORIDA AVE S",
            "address_2": "STE. 6",
            "city": "ROCKLEDGE",
            "state": "FL",
            "postal_code": "329552152",
            "telephone_number": "321-634-3688",
            "fax_number": "321-504-0955"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DUMPHY",
        "first_name": "TRACEY",
        "middle_name": "RENEE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-09-23",
        "last_updated": "2008-09-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "FL",
            "license": "OT 13317",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "OT 13317",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• All providers in Rockledge, FL
• Occupational Therapist in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 23, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.