NPIMap

Organization Active NPI

Tracey Jones, M.D., P.C.

Doing business as PsychPhilly

  • Psychiatry Physician
  • Philadelphia, PA
National Provider Identifier
1376768127
Registry record updated Jul 7, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
MD064120L Issued in PA
Legal business name
TRACEY JONES, M.D., P.C.
Doing business as
PsychPhilly
Practice address
1511 Carpenter St
Philadelphia, PA 19146-2110
Phone
(215) 923-2690
Fax
(215) 923-8940
NPI assigned
Apr 16, 2007
Last updated
Jul 7, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 7, 2023

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

Authorized official

Name
Tracey Jones, M.D.NPI 1043361355
Title
President
Phone
(215) 923-2690

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X MD064120L PA Primary
Child & Adolescent Psychiatry Physician 2084P0804X MD064120L PA

Addresses

Primary practice location

1511 Carpenter St
Philadelphia, PA 19146-2110

Mailing address

1511 Carpenter St
Philadelphia, PA 19146-2110
Phone (215) 923-2690

Other names 1

  • PsychPhilly Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20120329000340 PA Part B Supplier - Clinic/Group Practice 2769642784 Receives reassigned benefits from 1 practitioner
Practice locations: Philadelphia, PA

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1176681600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1688688000000",
    "number": "1376768127",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1511 CARPENTER ST",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191462110",
            "telephone_number": "215-923-2690",
            "fax_number": "215-923-8940"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1511 CARPENTER ST",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191462110",
            "telephone_number": "215-923-2690",
            "fax_number": "215-923-8940"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TRACEY JONES, M.D., P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-16",
        "last_updated": "2023-07-07",
        "certification_date": "2023-07-07",
        "status": "A",
        "authorized_official_last_name": "JONES",
        "authorized_official_first_name": "TRACEY",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "215-923-2690",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "PA",
            "license": "MD064120L",
            "primary": true
        },
        {
            "code": "2084P0804X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Child & Adolescent Psychiatry",
            "state": "PA",
            "license": "MD064120L",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "PsychPhilly",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Philadelphia, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 7, 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.