Individual provider Active NPI

Tracy Leigh Schofield, PMHNP

  • Psychiatric/Mental Health Nurse Practitioner
  • Wake Forest, NC
National Provider Identifier
1205550407
Registry record updated Nov 15, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
5017240 Issued in NC
Practice address
1748 Heritage Center Dr Ste 101
Wake Forest, NC 27587-9855
Phone
(919) 529-5920
NPI assigned
Sep 30, 2022
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 15, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Registered Nurse 163WP0808X 214675 NC
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 5017240 NC Primary

Addresses

Primary practice location

1748 Heritage Center Dr Ste 101
Wake Forest, NC 27587-9855

Mailing address

1748 Heritage Center Dr Ste 101
Wake Forest, NC 27587-9855
Phone (919) 529-5920

Other names 1

  • Tracy Leigh Pacilio Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230104002060 NC Practitioner - Nurse Practitioner 5092185280

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
214675NCMDPsychiatric/Mental Health Registered Nurse
5017240NCMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Cedar Oaks Clinic PLLC Psychiatric/Mental Health CurrentSince Jan 3, 2023 Accepting new patients

Locations

1748 Heritage Center Dr
Ste 101
Wake Forest, NC 27587
Phone (919) 529-5920

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1664496000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1668470400000",
    "number": "1205550407",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1748 HERITAGE CENTER DR STE 101",
            "city": "WAKE FOREST",
            "state": "NC",
            "postal_code": "275879855",
            "telephone_number": "919-529-5920"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1748 HERITAGE CENTER DR STE 101",
            "city": "WAKE FOREST",
            "state": "NC",
            "postal_code": "275879855",
            "telephone_number": "919-529-5920"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SCHOFIELD",
        "first_name": "TRACY",
        "middle_name": "LEIGH",
        "credential": "PMHNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-09-30",
        "last_updated": "2022-11-15",
        "certification_date": "2022-11-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WP0808X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Psychiatric/Mental Health",
            "state": "NC",
            "license": "214675",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "NC",
            "license": "5017240",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "TRACY",
            "last_name": "PACILIO",
            "middle_name": "LEIGH",
            "credential": "PMHNP",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Wake Forest, NC

Sources for this page

Verify at the official NPI Registry.