Tracy Wade Marx, DMIN, TCADC

Primary specialty

Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X

Practice address

213 Midland Blvd
Shelbyville, KY 40065-7791

Phone

(502) 647-0154

Fax

(502) 633-4043

NPI assigned

Sep 27, 2021

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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.

• CRC Health Treatment Clinics, LLC

  • Methadone Clinic
  • Shelbyville, KY
  • NPI 1235675125
  NPD (past)

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

{
    "created_epoch": "1632700800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1632700800000",
    "number": "1225709405",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10529 WATTERSON TRL APT 4",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402993792",
            "telephone_number": "502-819-0628"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "213 MIDLAND BLVD",
            "city": "SHELBYVILLE",
            "state": "KY",
            "postal_code": "400657791",
            "telephone_number": "502-647-0154",
            "fax_number": "502-633-4043"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARX",
        "first_name": "TRACY",
        "middle_name": "WADE",
        "name_prefix": "Dr.",
        "credential": "DMIN, TCADC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2021-09-27",
        "last_updated": "2021-09-27",
        "certification_date": "2021-09-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "tracy.marx@ctcprograms.com",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "213 Midland Blvd",
            "city": "Shelbyville",
            "state": "KY",
            "country_code": "US",
            "postal_code": "400657791",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Kenneth Edwin Marshall, MD
• Amy L Martin
• Ashlyn Delaney Martin, PA-C
• Frank J Martin, M.D.
• Laura Martin, PA-C
• Masonic Homes of Kentucky Inc
• Brook Thomas Massey, MD
• Melinda Matthews
• Max Performance Physical Therapy and Sports Rehab, LLC
• Maxcare Medical Services, PLLC

• Addiction (Substance Use Disorder) Counselor in Shelbyville, KY
• Providers in Shelbyville, KY by specialty
• Addiction (Substance Use Disorder) Counselor in Kentucky

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 27, 2021; 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.