NPIMap

Individual provider Active NPI

Tracey Merriman

  • Primary Care Nurse Practitioner
  • Westlake, OH
National Provider Identifier
1275057325
Registry record updated Dec 20, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Primary Care Nurse PractitionerTaxonomy code 363LP2300X
License
APRN.CNP.021589 Issued in OH
Practice address
29000 Center Ridge Rd
Westlake, OH 44145-5219
Phone
(440) 827-5559
NPI assigned
Jul 31, 2017
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 20, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Gastroenterology Physician 207RG0100X APRN.CNP.021589 OH
Primary Care Nurse Practitioner 363LP2300X APRN.CNP.021589 OH Primary

Addresses

Primary practice location

29000 Center Ridge Rd
Westlake, OH 44145-5219

Mailing address

5455 N Marginal Rd Apt 515
Cleveland, OH 44114-3951

Other names 1

  • Tracey Judd Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20170919000708 OH Practitioner - Nurse Practitioner 4082988845 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

158 W Main Rd
Conneaut, OH 44030-2039

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Certified Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
APRN.CNP.021589OHMDGastroenterology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
University Hospitals Cleveland Medical Center CurrentSince Oct 15, 2018 Accepting new patients
University Primary Care Practices Inc CurrentSince Dec 23, 2024 Accepting new patients
University Hospitals St. John Medical Center CurrentSince Oct 22, 2019 Accepting new patients
University Primary Care Practices Inc CurrentSince Dec 23, 2024 Accepting new patients
University Primary Care Practices Inc Gastroenterology Current Accepting new patients
University Hospitals Medical Group Inc CurrentSince Sep 8, 2017 Accepting new patients
University Hospitals Cleveland Medical Center CurrentSince Oct 15, 2018 Accepting new patients

Locations

8055 Mayfield Rd
Ste 105
Chesterland, OH 44026
Phone (440) 214-8024

11100 Euclid Ave
Cleveland Heights, OH 44106

158 W Main Rd
Ste 203
Conneaut, OH 44030
Phone (440) 285-2960

29000 Center Ridge Rd
Westlake, OH 44145
Phone (440) 414-6046

Interoperability endpoints

  • Direct secure messaging: tjudd28233@ehrdirect.uhhospitals.org

Organizations & group practices 7

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.

Hospital & facility affiliations 5

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1501459200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1734652800000",
    "number": "1275057325",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5455 N MARGINAL RD APT 515",
            "city": "CLEVELAND",
            "state": "OH",
            "postal_code": "441143951"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "29000 CENTER RIDGE RD",
            "city": "WESTLAKE",
            "state": "OH",
            "postal_code": "441455219",
            "telephone_number": "440-827-5559"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MERRIMAN",
        "first_name": "TRACEY",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-07-31",
        "last_updated": "2024-12-20",
        "certification_date": "2024-12-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "OH",
            "license": "APRN.CNP.021589",
            "primary": false
        },
        {
            "code": "363LP2300X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Primary Care",
            "state": "OH",
            "license": "APRN.CNP.021589",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "TRACEY",
            "last_name": "JUDD",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Westlake, OH

Sources for this page

Verify at the official NPI Registry.