Active NPI
Tracy Houston, ATC
- Athletic Trainer
- Prairie Grove, AR
National Provider Identifier
1164819330
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Athletic Trainer
- License
- 110102278
- Practice address
- 500 Cole Dr
Prairie Grove, AR 72753-2509 - Phone
- (479) 846-4212
- NPI assigned
- Apr 24, 2015
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Athletic Trainer | 2255A2300X | 110102278 | AR | Primary |
Addresses
Primary practice location
500 Cole Dr
Prairie Grove, AR 72753-2509
Mailing address
13641 Loren LN
Fayetteville, AR 72704-8413
Phone (479) 422-0218
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 110102278 | AR | MD | Athletic Trainer |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1429833600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1429833600000",
"number": "1164819330",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "13641 LOREN LN",
"city": "FAYETTEVILLE",
"state": "AR",
"postal_code": "727048413",
"telephone_number": "479-422-0218"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "500 COLE DR",
"city": "PRAIRIE GROVE",
"state": "AR",
"postal_code": "727532509",
"telephone_number": "479-846-4212"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HOUSTON",
"first_name": "TRACY",
"credential": "ATC",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2015-04-24",
"last_updated": "2015-04-24",
"status": "A"
},
"taxonomies": [
{
"code": "2255A2300X",
"taxonomy_group": "",
"desc": "Specialist/Technologist, Athletic Trainer",
"state": "AR",
"license": "110102278",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Prairie Grove, AR
- Trenton Colby Dunn, PHARM.D.
- Dynamic Physical Therapy and Performance
- Abigail Ellis, NP
- Matthew Thomas Feldner, PH.D.
- Horse-Play Outdoor Center, Inc
- Angie Hunton, MNSC, RNC OB
- Jennifer Bingham MD PLLC
- Kristin Leigh Jeremiah, BSN,RN
- John Pardo, DDS , PLLC (Buchanan Street Family Dentistry)
- Jonathan F. Shaver, O.D.
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 24, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.