Tracy Diane Black, M.S. CF-SLP

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

173256 Issued in KY

Practice address

1609 N Dixie Ave Ste 114
Elizabethtown, KY 42701-7494

Phone

(270) 827-4652

NPI assigned

Jun 1, 2017

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Science

State licenses

Practice roles

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.

• Community Living in Kentucky, LLC

  • Community/Behavioral Health Agency
  • Murray, KY
  • NPI 1518281419

  Speech-Language Pathologist

  NPD (past)
• Gateway Counseling Services

  • Community/Behavioral Health Agency
  • Bowling Green, KY
  • NPI 1508278458
  NPD (past)

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

{
    "created_epoch": "1496275200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1255869434",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 51322",
            "city": "BOWLING GREEN",
            "state": "KY",
            "postal_code": "421025622",
            "telephone_number": "270-777-9283"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1609 N DIXIE AVE STE 114",
            "city": "ELIZABETHTOWN",
            "state": "KY",
            "postal_code": "427017494",
            "telephone_number": "270-827-4652"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BLACK",
        "first_name": "TRACY",
        "middle_name": "DIANE",
        "credential": "M.S. CF-SLP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-06-01",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "KY",
            "license": "173256",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Bio-Medical Applications of Kentucky, Inc. (Fresenius Medical Care Hardin County)
• Biren Desai MD PSC
• Brooke Bischoff, APRN, PMHNP
• Jennifer Bischoff, OTR/L
• Lily Gayle Black
• Donald Edward Blackburn, APRN
• Chelsea Blair, APSS
• Erika Sparks Blair, APRN
• Joshua Michael Blair, APSS
• Zachary Blair, APSS

• Speech-Language Pathologist in Elizabethtown, KY
• Providers in Elizabethtown, KY by specialty
• Speech-Language Pathologist in Kentucky

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; 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.