Individual provider Active NPI

Tracey Scott Welborn, RN

  • Medical-Surgical Registered Nurse
  • Richmond, VA
National Provider Identifier
1154570893
Registry record updated Sep 18, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical-Surgical Registered NurseTaxonomy code 163WM0705X
License
0001214226 Issued in VA
Practice address
10316 Ashburn Rd
Richmond, VA 23235-2604
Phone
(804) 272-7097
NPI assigned
Sep 18, 2008
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 18, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medical-Surgical Registered Nurse 163WM0705X 0001214226 VA Primary

Addresses

Primary practice location

10316 Ashburn Rd
Richmond, VA 23235-2604

Mailing address

10316 Ashburn Rd
Richmond, VA 23235-2604
Phone (804) 272-7097

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
Registered Nurse

State licenses

LicenseStateTypeSpecialty
0001214226VAMDMedical-Surgical Registered Nurse

NPI Registry JSON

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

{
    "created_epoch": "1221696000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1221696000000",
    "number": "1154570893",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10316 ASHBURN RD",
            "city": "RICHMOND",
            "state": "VA",
            "postal_code": "232352604",
            "telephone_number": "804-272-7097"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10316 ASHBURN RD",
            "city": "RICHMOND",
            "state": "VA",
            "postal_code": "232352604",
            "telephone_number": "804-272-7097"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WELBORN",
        "first_name": "TRACEY",
        "middle_name": "SCOTT",
        "name_prefix": "Mr.",
        "credential": "RN",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2008-09-18",
        "last_updated": "2008-09-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WM0705X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Medical-Surgical",
            "state": "VA",
            "license": "0001214226",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Richmond, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 18, 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.