Tracie E Walterscheid, PA

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

4636 Issued in CO

Practice address

123 Emma Rd
Basalt, CO 81621-9169

Phone

(970) 945-2840

Fax

(970) 945-2893

NPI assigned

May 4, 2012

Last updated

Jan 4, 2019By the provider in NPPES

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 names 1

• Tracie McKinley Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Interoperability endpoints

• Direct secure messaging: tracie.mckinley@direct.myteamcare.com

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.

• Mountain Family Health Centers

  • Federally Qualified Health Center (FQHC)
  • Basalt, CO
  • NPI 1548569924
  NPD (past)

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

{
    "created_epoch": "1336089600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1546560000000",
    "number": "1225397672",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2700 GILSTRAP CT STE 230",
            "city": "GLENWOOD SPRINGS",
            "state": "CO",
            "postal_code": "816018735",
            "telephone_number": "970-945-2840",
            "fax_number": "970-945-2893"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "123 EMMA RD",
            "city": "BASALT",
            "state": "CO",
            "postal_code": "816219169",
            "telephone_number": "970-945-2840",
            "fax_number": "970-945-2893"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WALTERSCHEID",
        "first_name": "TRACIE",
        "middle_name": "E",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-05-04",
        "last_updated": "2019-01-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "TX",
            "license": "PA07788",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CO",
            "license": "4636",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "TRACIE",
            "last_name": "MCKINLEY",
            "credential": "PA",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Valley View Hospital Association
• Valley View Hospital Association (Valley View Surgery Center at Basalt)
• Valley View Hospital Association (Roaring Fork Family Practice)
• Megan Verros, MSW MPH
• Lisa Marie Wagner, APN NP-C
• Elizabeth Cockrill Ward, CMT
• Lindsay Williams, RDH
• Win Hbo (Colorado Center for Hyperbaric Medicine)
• Win Health Institute, LLC
• Win Wellness Institute

• Physician Assistant in Basalt, CO
• Providers in Basalt, CO by specialty
• Physician Assistant in Colorado

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 4, 2019; 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.