Tracy Ann Derr, LPN

Primary specialty

Licensed Practical NurseTaxonomy code 164W00000X

License

0000066774 Issued in TN

Practice address

1238 Gadd Rd.
Hixson, TN 37343

Phone

(423) 875-4806

Fax

(423) 874-0094

NPI assigned

Jul 13, 2009

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other names 1

• Mrs. Tracy Ann Derr Professional name

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.

{
    "created_epoch": "1247443200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1247443200000",
    "number": "1154550101",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1238 GADD RD",
            "city": "HIXSON",
            "state": "TN",
            "postal_code": "373433917",
            "telephone_number": "423-875-4806",
            "fax_number": "423-874-0094"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1238 GADD RD.",
            "city": "HIXSON",
            "state": "TN",
            "postal_code": "37343",
            "telephone_number": "423-875-4806",
            "fax_number": "423-874-0094"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DERR",
        "first_name": "TRACY",
        "middle_name": "ANN",
        "name_prefix": "Mrs.",
        "credential": "LPN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2009-07-13",
        "last_updated": "2009-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "TN",
            "license": "0000066774",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "TRACY",
            "last_name": "DERR",
            "middle_name": "ANN",
            "prefix": "MRS.",
            "credential": "LPN",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

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• All providers in Hixson, TN
• Licensed Practical Nurse in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 2009; 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.