Individual provider Active NPI

Tracy Jordan, CCC-SLP

  • Speech-Language Pathologist
  • Franconia, NH
National Provider Identifier
1255720199
Registry record updated Jun 2, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
SP2250 Issued in ME
Practice address
1095 Profile Rd
Franconia, NH 03580-4938
Phone
(603) 823-8600
NPI assigned
Jan 15, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 2, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Speech-Language Pathologist 235Z00000X 3214 NH
Speech-Language Pathologist 235Z00000X SP2250 ME Primary

Addresses

Primary practice location

1095 Profile Rd
Franconia, NH 03580-4938

Mailing address

95 Edencroft Rd
Littleton, NH 03561-4417
Phone (802) 535-2471

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NH

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250609001880 NH Practitioner - Qualified Speech Language Pathologist 7810407962 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
3214NHMDPediatric Dentist
SP2250MEMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Littleton Hospital Association Current Accepting new patients
Littleton Hospital Association CurrentSince Apr 4, 2025 Accepting new patients
Littleton Hospital Association CurrentSince Apr 4, 2025 Accepting new patients
Southern Maine Chidlren'S Academy, LLC PastSince Jun 9, 2024 Accepting new patients
Southern Maine Speech & Language Services, LLC Speech-Language Pathologist Past Accepting new patients

Locations

1095 Profile Rd
Franconia, NH 03580
Phone (603) 823-8600

600 Saint Johnsbury Rd
Littleton, NH 03561
Phone (603) 444-9000

580 Saint Johnsbury Rd
Littleton, NH 03561
Phone (603) 444-0385

Organizations & group practices 5

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.

NPI Registry JSON

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

{
    "created_epoch": "1421280000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1748822400000",
    "number": "1255720199",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "95 EDENCROFT RD",
            "city": "LITTLETON",
            "state": "NH",
            "postal_code": "035614417",
            "telephone_number": "802-535-2471"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1095 PROFILE RD",
            "city": "FRANCONIA",
            "state": "NH",
            "postal_code": "035804938",
            "telephone_number": "603-823-8600"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JORDAN",
        "first_name": "TRACY",
        "name_prefix": "Mrs.",
        "credential": "CCC-SLP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-01-15",
        "last_updated": "2025-06-02",
        "certification_date": "2025-05-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "NH",
            "license": "3214",
            "primary": false
        },
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "ME",
            "license": "SP2250",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Franconia, NH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 2, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.