Individual provider Active NPI

Tracy Call-Schmidt

  • Nurse Practitioner
  • Provo, UT
National Provider Identifier
1417941196
Registry record updated Oct 29, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
325608-4405 Issued in UT
Practice address
280 River Park Dr Ste 200
Provo, UT 84604-5793
Phone
(801) 232-4860
Fax
(801) 371-8993
NPI assigned
Sep 8, 2005
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 29, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 325608-4405 UT Primary

Addresses

Primary practice location

280 River Park Dr Ste 200
Provo, UT 84604-5793

Mailing address

280 W River Park Dr #200
Provo, UT 84604
Phone (801) 223-4860

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in UT
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 1

Enrollment IDStateProvider typePAC IDDetails
I20040302000400 UT Practitioner - Nurse Practitioner 2860389152 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
325608-4405UTMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Spinal Interventions, PLLC CurrentSince Oct 1, 2015 Accepting new patients
Omega Interventional Pain PLLC Past Accepting new patients
Lifetree Medical Inc Past Accepting new patients

Locations

280 River Park Dr
Ste 350
Provo, UT 84604
Phone (801) 223-4860

280 River Park Dr
Ste 200
Provo, UT 84604
Phone (801) 223-4860

Organizations & group practices 3

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": "1126137600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1540771200000",
    "number": "1417941196",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "280 W RIVER PARK DR #200",
            "city": "PROVO",
            "state": "UT",
            "postal_code": "84604",
            "telephone_number": "801-223-4860",
            "fax_number": "801-371-8993"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "280 RIVER PARK DR STE 200",
            "city": "PROVO",
            "state": "UT",
            "postal_code": "846045793",
            "telephone_number": "801-232-4860",
            "fax_number": "801-371-8993"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CALL-SCHMIDT",
        "first_name": "TRACY",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-09-08",
        "last_updated": "2018-10-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "UT",
            "license": "325608-4405",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Provo, UT

Sources for this page

Verify at the official NPI Registry.