Traci Duncan Green, MPT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

PT16099 Issued in FL

Practice address

424 College Blvd.
Valparaiso, FL 32580

Phone

(850) 378-2600

Fax

(833) 869-6437

NPI assigned

Sep 9, 2010

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

Other names 1

• Traci Lyn Duncan Former name

Medicare fee-for-service enrollment

Enrolled in FL

Enrollment records 1

Specialty

Physical Therapist in Private Practice

Education

Other, 1996

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

Interoperability endpoints

• Direct secure messaging: traci.green.1@15074.direct.athenahealth.com

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.

• 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": "1283990400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1635811200000",
    "number": "1316254477",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6021 STERLING RIVER WAY",
            "city": "NICEVILLE",
            "state": "FL",
            "postal_code": "32578",
            "telephone_number": "850-378-2600",
            "fax_number": "833-869-6437"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "424 COLLEGE BLVD.",
            "city": "VALPARAISO",
            "state": "FL",
            "postal_code": "32580",
            "telephone_number": "850-378-2600",
            "fax_number": "833-869-6437"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GREEN",
        "first_name": "TRACI",
        "middle_name": "DUNCAN",
        "credential": "MPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-09-09",
        "last_updated": "2021-11-02",
        "certification_date": "2021-11-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "FL",
            "license": "PT16099",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "TRACI",
            "last_name": "DUNCAN",
            "middle_name": "LYN",
            "credential": "MPT",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Rachael Flint
• Kristin Joy Freeland, SPEECH LANGUAGE PATH
• Summer Fritz, NP
• Jennifer Leigh Gaddy, DPT
• Sarah Joanna Green, DC
• Erica Cameron Griffin, LMHC
• Growing Green Families, PLLC
• Kavitha Prasad Hardy, M.D.
• Sherrel Hill, BCBA
• I3M Wellness LLC

• Physical Therapist in Valparaiso, FL
• Providers in Valparaiso, FL by specialty
• Physical Therapist in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 2, 2021; 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.