Tracy Walck, OT

Primary specialty

Occupational TherapistTaxonomy code 225X00000X

License

OT22453 Issued in FL

Practice address

101 McAbee CT
Gulf Breeze, FL 32561-4756

Phone

(850) 748-2841

NPI assigned

Feb 7, 2022

Last updated

Feb 7, 2022By the provider in NPPES

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

Enrolled in FL

Enrollment records 1

Specialty

Occupational Therapist in Private Practice

Education

Other, 2021

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Action Therapy Group LLCGroup PAC ID 6305258013, 69 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Action Therapy Group LLC

  • Physical Therapist
  • Jay, FL
  • NPI 1548861602
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1644192000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1644192000000",
    "number": "1275287443",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3331 SUMMIT BLVD APT 172",
            "city": "PENSACOLA",
            "state": "FL",
            "postal_code": "325034331",
            "telephone_number": "850-741-6715",
            "fax_number": "850-240-0489"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "101 MCABEE CT",
            "city": "GULF BREEZE",
            "state": "FL",
            "postal_code": "325614756",
            "telephone_number": "850-748-2841"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WALCK",
        "first_name": "TRACY",
        "credential": "OT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-02-07",
        "last_updated": "2022-02-07",
        "certification_date": "2022-02-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "FL",
            "license": "OT22453",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Brid M Wade, APRN
• Maddie A Wagoner, ATS
• Wal-Mart Stores East LP (WalMart Pharmacy 10-5623)
• Wal-Mart Stores East LP (Walmart Pharmacy 10-2533)
• Wal-Mart Stores East, LP (Vision Center 30-2533)
• Walgreen Co (Walgreens #06210)
• Walgreens Pharmacy
• Brandy Annette Walker
• Kelli Nicole Walker
• Harlan David Wallner, RMHCI

• Occupational Therapist in Gulf Breeze, FL
• Providers in Gulf Breeze, FL by specialty
• Occupational Therapist in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 7, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.