Active NPI
Tracy M Ross, M.DIV.
- Pastoral Counselor
- Indianapolis, IN
National Provider Identifier
1336312263
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pastoral Counselor
- Practice address
- 4218 Guion Lakes Ter
Indianapolis, IN 46254-1594 - Phone
- (317) 664-1390
- NPI assigned
- Apr 11, 2008
- Sex
- Female
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Pastoral Counselor | 101YP1600X | Primary |
Addresses
Primary practice location
4218 Guion Lakes Ter
Indianapolis, IN 46254-1594
Mailing address
PO Box 53224
Indianapolis, IN 46253-0224
Phone (317) 664-1390
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 201034050A | Medicaid | IN |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1207872000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1320969600000",
"number": "1336312263",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 53224",
"city": "INDIANAPOLIS",
"state": "IN",
"postal_code": "462530224",
"telephone_number": "317-664-1390"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4218 GUION LAKES TER",
"city": "INDIANAPOLIS",
"state": "IN",
"postal_code": "462541594",
"telephone_number": "317-664-1390"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ROSS",
"first_name": "TRACY",
"middle_name": "M",
"credential": "M.DIV.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2008-04-11",
"last_updated": "2011-11-11",
"status": "A"
},
"taxonomies": [
{
"code": "101YP1600X",
"taxonomy_group": "",
"desc": "Counselor, Pastoral",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "201034050A",
"state": "IN"
}
],
"endpoints": [],
"other_names": []
}Other providers in Indianapolis, IN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 11, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.