Tracey O'Neill, CNS, LDN

Primary specialty

Registered DietitianTaxonomy code 133V00000X

License

DX5575 Issued in MD

Practice address

500 Canal Rd
Ponte Vedra Beach, FL 32082-4300

Phone

(904) 535-6901

NPI assigned

Feb 14, 2022

Sex

Female

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Enrolled in FL

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Certified Nurse Specialist

State licenses

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

{
    "created_epoch": "1644796800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1677196800000",
    "number": "1356096887",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "500 CANAL RD",
            "city": "PONTE VEDRA BEACH",
            "state": "FL",
            "postal_code": "320824300",
            "telephone_number": "904-535-6901"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "500 CANAL RD",
            "city": "PONTE VEDRA BEACH",
            "state": "FL",
            "postal_code": "320824300",
            "telephone_number": "904-535-6901"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "O'NEILL",
        "first_name": "TRACEY",
        "credential": "CNS, LDN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-02-14",
        "last_updated": "2023-02-24",
        "certification_date": "2023-02-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "FL",
            "license": "ND11248",
            "primary": false
        },
        {
            "code": "171400000X",
            "taxonomy_group": "",
            "desc": "Health & Wellness Coach",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "MD",
            "license": "DX5575",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• North Florida Surgeons, PA
• Northeast Florida Wellness PLLC
• Renata Nosek, M.A.
• James November, PHD
• Elizabeth Cox Nurrenbrock, M.A. CCC-SLP
• Occuplay Inc
• Jason Samuel Olitsky
• Erica Oppenheimer, LMSW
• Nina Oriolo, BSN
• Emily Ortiz

• Registered Dietitian in Ponte Vedra Beach, FL
• Providers in Ponte Vedra Beach, FL by specialty
• Registered Dietitian in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 24, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.