Active NPI
Tracy Fekete, M.S. CCC-SLP
- Speech-Language Pathologist
- Las Vegas, NV
National Provider Identifier
1114567286
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Speech-Language Pathologist
- License
- 24420770
- 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
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| 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
| License | State | Type | Specialty |
|---|---|---|---|
| 30653 | CA | MD | Pharmacist |
| 14040 | CA | MD | Family Medicine Physician |
| 24420770 | CO | MD | Speech-Language Pathologist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Lucid Speech and Language Clinic, Inc. | Speech-Language Pathologist | Past | Accepting new patients |
| Lucid Speech & Language | Speech-Language Pathologist | Past | 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.
-
- Speech-Language Pathologist
- Murrieta, CA
- NPI 1336240324
-
- Speech-Language Pathologist
- Murrieta, CA
- NPI 1457805251
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.