Individual provider Active NPI

Tracey Diane Saddler, LPN

  • Licensed Practical Nurse
  • Newport News, VA
National Provider Identifier
1235210733
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Licensed Practical NurseTaxonomy code 164W00000X
License
0002066434 Issued in VA
Practice address
19 Winston Ave
Newport News, VA 23601-2122
Phone
(757) 595-4226
NPI assigned
Oct 18, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Licensed Practical Nurse 164W00000X 0002066434 VA Primary

Addresses

Primary practice location

19 Winston Ave
Newport News, VA 23601-2122

Mailing address

19 Winston Ave
Newport News, VA 23601-2122
Phone (757) 595-4226

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
0002066434VAMDLicensed Practical Nurse

NPI Registry JSON

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

{
    "created_epoch": "1161129600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1235210733",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "19 WINSTON AVE",
            "city": "NEWPORT NEWS",
            "state": "VA",
            "postal_code": "236012122",
            "telephone_number": "757-595-4226"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "19 WINSTON AVE",
            "city": "NEWPORT NEWS",
            "state": "VA",
            "postal_code": "236012122",
            "telephone_number": "757-595-4226"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SADDLER",
        "first_name": "TRACEY",
        "middle_name": "DIANE",
        "credential": "LPN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-10-18",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "VA",
            "license": "0002066434",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Newport News, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.