Individual provider Active NPI

Tracy Fekete, M.S. CCC-SLP

  • Speech-Language Pathologist
  • Las Vegas, NV
National Provider Identifier
1114567286
Registry record updated Feb 29, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
24420770 Issued in CO
Practice address
10629 Mount Blackburn Ave
Las Vegas, NV 89166-5052
Phone
(630) 391-1398
NPI assigned
Jan 7, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 29, 2024

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Speech-Language Pathologist 235Z00000X 24420770 CO Primary
Speech-Language Pathologist 235Z00000X 14040 CA
Speech-Language Pathologist 235Z00000X 30653 CA

Addresses

Primary practice location

10629 Mount Blackburn Ave
Las Vegas, NV 89166-5052

Mailing address

5130 Durham CT
Denver, CO 80239-4146
Phone (630) 391-1398

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
Master of Science

State licenses

LicenseStateTypeSpecialty
30653CAMDPharmacist
14040CAMDFamily Medicine Physician
24420770COMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Lucid Speech and Language Clinic, Inc. Speech-Language Pathologist PastSince Jan 1, 2020 Accepting new patients
Lucid Speech & Language Speech-Language Pathologist PastSince Jan 1, 2020 Accepting new patients

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1578355200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1709164800000",
    "number": "1114567286",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5130 DURHAM CT",
            "city": "DENVER",
            "state": "CO",
            "postal_code": "802394146",
            "telephone_number": "630-391-1398"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10629 MOUNT BLACKBURN AVE",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891665052",
            "telephone_number": "630-391-1398"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FEKETE",
        "first_name": "TRACY",
        "credential": "M.S. CCC-SLP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-01-07",
        "last_updated": "2024-02-29",
        "certification_date": "2024-02-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "CO",
            "license": "24420770",
            "primary": true
        },
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "CA",
            "license": "14040",
            "primary": false
        },
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "CA",
            "license": "30653",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Las Vegas, NV

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 29, 2024; 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.