Individual provider Active NPI

Tracy G Assante

  • Speech-Language Pathologist
  • Fuquay Varina, NC
National Provider Identifier
1396922811
Registry record updated Sep 4, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
7712 Issued in NC
Practice address
141 N Main St
Fuquay Varina, NC 27526-1933
Phone
(919) 577-6807
NPI assigned
Jan 28, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 4, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Speech-Language Pathologist 235Z00000X 7712 NC Primary

Addresses

Primary practice location

141 N Main St
Fuquay Varina, NC 27526-1933

Mailing address

528 Barneswyck Dr
Fuquay Varina, NC 27526-2276
Phone (919) 508-6897

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20200910003219 NC Practitioner - Qualified Speech Language Pathologist 6507284338 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science

State licenses

LicenseStateTypeSpecialty
7712NCMDProfessional Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Capitol City Speech Therapy, LLC Speech-Language Pathologist CurrentSince Aug 18, 2020 Accepting new patients

Locations

141 N Main St
Fuquay Varina, NC 27526
Phone (919) 577-6807

1330 Saint Marys St
Ste 100
Raleigh, NC 27605
Phone (919) 577-6807

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1201478400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1599177600000",
    "number": "1396922811",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "528 BARNESWYCK DR",
            "city": "FUQUAY VARINA",
            "state": "NC",
            "postal_code": "275262276",
            "telephone_number": "919-508-6897"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "141 N MAIN ST",
            "city": "FUQUAY VARINA",
            "state": "NC",
            "postal_code": "275261933",
            "telephone_number": "919-577-6807"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ASSANTE",
        "first_name": "TRACY",
        "middle_name": "G",
        "name_prefix": "Mrs.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-01-28",
        "last_updated": "2020-09-04",
        "certification_date": "2020-09-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "NC",
            "license": "7712",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fuquay Varina, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 4, 2020; 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.