Individual provider Active NPI

Tracy Whitehurst

  • Licensed Vocational Nurse
  • Lake Worth, FL
National Provider Identifier
1235762196
Registry record updated Feb 19, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Licensed Vocational NurseTaxonomy code 164X00000X
License
PN5197616 Issued in FL
Practice address
7880 Sonoma Springs Cir Apt 105
Lake Worth, FL 33463-7935
Phone
(561) 644-1299
NPI assigned
Feb 19, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 19, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Licensed Vocational Nurse 164X00000X PN5197616 FL Primary

Addresses

Primary practice location

7880 Sonoma Springs Cir Apt 105
Lake Worth, FL 33463-7935

Mailing address

7880 Sonoma Springs Cir Apt 105
Lake Worth, FL 33463-7935
Phone (561) 644-1299

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
PN5197616FLMDLicensed Vocational Nurse

NPI Registry JSON

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

{
    "created_epoch": "1582070400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1582070400000",
    "number": "1235762196",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7880 SONOMA SPRINGS CIR APT 105",
            "city": "LAKE WORTH",
            "state": "FL",
            "postal_code": "334637935",
            "telephone_number": "561-644-1299"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7880 SONOMA SPRINGS CIR APT 105",
            "city": "LAKE WORTH",
            "state": "FL",
            "postal_code": "334637935",
            "telephone_number": "561-644-1299"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WHITEHURST",
        "first_name": "TRACY",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-02-19",
        "last_updated": "2020-02-19",
        "certification_date": "2020-02-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164X00000X",
            "taxonomy_group": "",
            "desc": "Licensed Vocational Nurse",
            "state": "FL",
            "license": "PN5197616",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lake Worth, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 19, 2020; 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.