Traci Thornsbury, APRN

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

92307 Issued in WV

Practice address

104 Logan St Ste a
Williamson, WV 25661-3606

Phone

(304) 236-5902

NPI assigned

Jul 18, 2016

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in KY, WV2 enrollments

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 2

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

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.

• Williamson Health & Wellness Center Inc

  dba Williamson Health & Wellness Center-Behavioral Medicine Clinic

  • Federally Qualified Health Center (FQHC)
  • Williamson, WV
  • NPI 1386115905
  Medicare reassignment NPD
• Williamson Health & Wellness Center Inc

  • Federally Qualified Health Center (FQHC)
  • Williamson, WV
  • NPI 1467711150
  Medicare reassignment NPD
• Williamson Health & Wellness Center Inc

  dba Williamson Health & Wellness Center - Gilbert

  • Federally Qualified Health Center (FQHC)
  • Gilbert, WV
  • NPI 1730669524
  Medicare reassignment NPD
• Williamson Memorial, Inc.

  • General Acute Care Hospital
  • Williamson, WV
  • NPI 1013521228
  Medicare reassignment NPD
• Grow Healthcare Group PA

  • Mental Health Counselor
  • Miami, FL
  • NPI 1245845932

  KY

  Medicare reassignment
• Williamson Health & Wellness Center Inc

  dba Williamson Health & Wellness Center-Mingo Central High School

  • Federally Qualified Health Center (FQHC)
  • Delbarton, WV
  • NPI 1225684731
  NPD
• Williamson Health & Wellness Center Inc

  dba Williamson Health & Wellness Center - Alderson Clinic

  • Federally Qualified Health Center (FQHC)
  • Williamson, WV
  • NPI 1700445798
  NPD
• Williamson Health & Wellness Center Inc

  dba Williamson Health & Wellness Center -Licensed Behavioral Health Center

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Williamson, WV
  • NPI 1942840384
  NPD
• Williamson Memorial, Inc.

  • Emergency Medicine Physician
  • Williamson, WV
  • NPI 1174345243
  NPD

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

{
    "created_epoch": "1468800000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1704240000000",
    "number": "1407209299",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2080",
            "city": "WILLIAMSON",
            "state": "WV",
            "postal_code": "256612080",
            "telephone_number": "304-236-5902",
            "fax_number": "855-487-4047"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "104 LOGAN ST STE A",
            "city": "WILLIAMSON",
            "state": "WV",
            "postal_code": "256613606",
            "telephone_number": "304-236-5902"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "184 E 2nd Ave Ste 210",
            "address_purpose": "LOCATION",
            "city": "Williamson",
            "state": "WV",
            "postal_code": "256613602",
            "country_code": "US",
            "telephone_number": "304-236-5902",
            "fax_number": "855-487-4047",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "THORNSBURY",
        "first_name": "TRACI",
        "credential": "APRN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-07-18",
        "last_updated": "2024-01-03",
        "certification_date": "2024-01-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "WV",
            "license": "92307",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "WV",
            "license": "92307",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7100443080",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Stephanie Teeters
• Victorino Rodriguez Teleron Jr., M.D
• Angela Tester
• Kandal Lynn Thacker
• Edna Thompson
• Kizzie Niajuana Thorpe
• Nathan Joe Tomblin
• Theresa Tomsovic
• Kandice Alicia Trejo, NA
• Vanessa Trent

• Psychiatric/Mental Health Nurse Practitioner in Williamson, WV
• Providers in Williamson, WV by specialty
• Psychiatric/Mental Health Nurse Practitioner in West Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 3, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.