Active NPI
Traci D Mahood
- Nurse Practitioner
- Waterloo, IA
National Provider Identifier
1295376846
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Nurse Practitioner
- License
- H156611
- Practice address
- 2710 Saint Francis Dr Ste 320
Waterloo, IA 50702-5620 - Phone
- (319) 272-8072
- NPI assigned
- Oct 4, 2019
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Nurse Practitioner | 363L00000X | H156611 | IA | Primary |
Addresses
Primary practice location
2710 Saint Francis Dr Ste 320
Waterloo, IA 50702-5620
Mailing address
2710 Saint Francis Dr Ste 320
Waterloo, IA 50702-5620
Phone (319) 272-8072
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: No
- Medical equipment: Yes
- Home health: No
- Power mobility devices: Yes
- Hospice: No
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
Interoperability endpoints
- tmahood3934328@direct.trinity-health.org
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1570147200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1570147200000",
"number": "1295376846",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2710 SAINT FRANCIS DR STE 320",
"city": "WATERLOO",
"state": "IA",
"postal_code": "507025620",
"telephone_number": "319-272-8072"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2710 SAINT FRANCIS DR STE 320",
"city": "WATERLOO",
"state": "IA",
"postal_code": "507025620",
"telephone_number": "319-272-8072"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MAHOOD",
"first_name": "TRACI",
"middle_name": "D",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2019-10-04",
"last_updated": "2019-10-04",
"status": "A"
},
"taxonomies": [
{
"code": "363L00000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner",
"state": "IA",
"license": "H156611",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Waterloo, IA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 4, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.