Individual provider Active NPI

Tracy Dawn Thangam, ACNP

  • Acute Care Nurse Practitioner
  • Saint Louis, MO
National Provider Identifier
1205305505
Registry record updated Mar 7, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Acute Care Nurse PractitionerTaxonomy code 363LA2100X
License
2018044914 Issued in MO
Practice address
1 Barnes Jewish Hospital PLZ
Saint Louis, MO 63110-1003
Phone
(314) 747-3581
Fax
(314) 747-1710
NPI assigned
Nov 15, 2018
Last updated
Mar 7, 2019By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 7, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Acute Care Nurse Practitioner 363LA2100X 2018044914 MO Primary

Addresses

Primary practice location

1 Barnes Jewish Hospital PLZ
Saint Louis, MO 63110-1003

Mailing address

660 S Euclid Ave
CB 8054
Saint Louis, MO 63110-1010
Phone (314) 747-3581

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Seton Family of Doctors CurrentSince Sep 13, 2024 Accepting new patients
Seton Family of Doctors CurrentSince Sep 13, 2024 Accepting new patients
Washington University Past Accepting new patients

Locations

1004 W 32nd St
Ste 300
Austin, TX 78705
Phone (512) 324-3440

1400 N Interstate 35
Ste 300
Austin, TX 78701
Phone (512) 324-8300

1500 Red River St
Austin, TX 78701
Phone (512) 324-0150

6001 Kyle Pkwy
Kyle, TX 78640
Phone (512) 504-5000

Organizations & group practices 3

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

NPI Registry JSON

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

{
    "created_epoch": "1542240000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1551916800000",
    "number": "1205305505",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "660 S EUCLID AVE",
            "address_2": "CB 8054",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631101010",
            "telephone_number": "314-747-3581",
            "fax_number": "314-747-1710"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 BARNES JEWISH HOSPITAL PLZ",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631101003",
            "telephone_number": "314-747-3581",
            "fax_number": "314-747-1710"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "THANGAM",
        "first_name": "TRACY",
        "middle_name": "DAWN",
        "name_prefix": "Ms.",
        "credential": "ACNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-11-15",
        "last_updated": "2019-03-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "MO",
            "license": "2018044914",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Saint Louis, MO

Sources for this page

Verify at the official NPI Registry.