Tracy Anne Marciniak, SLP

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

2010007402 Issued in MO

Practice address

1177 N. Warson Rd.
St. Louis, MO 63132

Phone

(314) 569-2211

Fax

(314) 569-3656

NPI assigned

Jun 17, 2009

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

Other names 1

• Tracy Anne Ball Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• St. Louis Arc

  • Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
  • Hazelwood, MO
  • NPI 1669658910
  NPD (past)
• St. Louis Arc Inc

  • Speech-Language Pathologist
  • St. Louis, MO
  • NPI 1215076898
  NPD (past)

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

{
    "created_epoch": "1245196800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1386806400000",
    "number": "1215164207",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1177 N. WARSON RD",
            "city": "ST. LOUIS",
            "state": "MO",
            "postal_code": "63132",
            "telephone_number": "314-569-2211",
            "fax_number": "314-569-3656"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1177 N. WARSON RD.",
            "city": "ST. LOUIS",
            "state": "MO",
            "postal_code": "63132",
            "telephone_number": "314-569-2211",
            "fax_number": "314-569-3656"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARCINIAK",
        "first_name": "TRACY",
        "middle_name": "ANNE",
        "credential": "SLP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-06-17",
        "last_updated": "2013-12-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "IA",
            "license": "001872",
            "primary": false
        },
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "MO",
            "license": "2010007402",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0665463",
            "state": "IA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "TRACY",
            "last_name": "BALL",
            "middle_name": "ANNE",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Natalie C March
• Lyudmyla Marchenko
• Jessica Evelyn Marchetto
• Laura Marchi, DNP, FNP-C
• Kenneth Ernest Marciniak, AUD
• Nicole Marco
• Abby Margaret Marcouiller, P.T.
• Margaret Sopuch Marcrander, M.D.
• Ioana Marcu
• Mirela D Marcu, MD

• Speech-Language Pathologist in St. Louis, MO
• Providers in St. Louis, MO by specialty
• Speech-Language Pathologist in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 12, 2013; 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.