Individual provider Active NPI

Tracy Leigh Wilde, BA

  • Peer Specialist
  • Broken Arrow, OK
National Provider Identifier
1104143213
Registry record updated Apr 17, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Peer SpecialistTaxonomy code 175T00000X
Practice address
7015 S Dogwood PL
Broken Arrow, OK 74011-2071
Phone
(918) 630-3566
NPI assigned
Apr 28, 2010
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 17, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Case Manager/Care Coordinator 171M00000X
Peer Specialist 175T00000X Primary

Addresses

Primary practice location

7015 S Dogwood PL
Broken Arrow, OK 74011-2071

Mailing address

7015 S Dogwood PL
Broken Arrow, OK 74011-2071
Phone (918) 630-3566

Other names 1

  • Mrs. Tracy Leigh Bigby Former name

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
Bachelor of Arts

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1272412800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1776384000000",
    "number": "1104143213",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7015 S DOGWOOD PL",
            "city": "BROKEN ARROW",
            "state": "OK",
            "postal_code": "740112071",
            "telephone_number": "918-630-3566"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7015 S DOGWOOD PL",
            "city": "BROKEN ARROW",
            "state": "OK",
            "postal_code": "740112071",
            "telephone_number": "918-630-3566"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILDE",
        "first_name": "TRACY",
        "middle_name": "LEIGH",
        "name_prefix": "Mrs.",
        "credential": "BA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-04-28",
        "last_updated": "2026-04-17",
        "certification_date": "2026-04-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "171M00000X",
            "taxonomy_group": "",
            "desc": "Case Manager/Care Coordinator",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "175T00000X",
            "taxonomy_group": "",
            "desc": "Peer Specialist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "TRACY",
            "last_name": "BIGBY",
            "middle_name": "LEIGH",
            "prefix": "MRS.",
            "credential": "BA",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Broken Arrow, OK

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 17, 2026; 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.