Individual provider Active NPI

Sarah C. Tracy

  • Speech-Language Pathologist
  • Lexington, SC
National Provider Identifier
1447768353
Registry record updated Mar 30, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
7345 Issued in SC
Practice address
460 Pin Oak Dr
Lexington, SC 29073-7916
Phone
(180) 371-4344
NPI assigned
Jan 12, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 30, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Behavior Technician 106S00000X 17-32737 SC
Speech-Language Pathologist 235Z00000X 7345 SC Primary

Addresses

Primary practice location

460 Pin Oak Dr
Lexington, SC 29073-7916

Mailing address

460 Pin Oak Dr
Lexington, SC 29073-7916
Phone (803) 714-3446

Other practice location 1

1048 Wildwood Centre Dr
Columbia, SC 29229-8420
Phone (803) 999-3752

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20210804000052 SC Practitioner - Qualified Speech Language Pathologist 7911301585 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
17-32737SCMDBehavior Technician
7345SCMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Elite Integrated Therapy Centers, LLC CurrentSince Aug 9, 2021 Accepting new patients
Meaningful Milestones LLC Behavior Technician PastSince Nov 29, 2020 Accepting new patients

Locations

2005 E Greenville St
Ste 119
Anderson, SC 29621
Phone (864) 512-7023

1007 Grove Rd
#A
Greenville, SC 29605

1007 Grove Rd
#C
Greenville, SC 29605

Organizations & group practices 2

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": "1515715200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1648598400000",
    "number": "1447768353",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "460 PIN OAK DR",
            "city": "LEXINGTON",
            "state": "SC",
            "postal_code": "290737916",
            "telephone_number": "803-714-3446",
            "fax_number": "803-824-6189"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "460 PIN OAK DR",
            "city": "LEXINGTON",
            "state": "SC",
            "postal_code": "290737916",
            "telephone_number": "180-371-4344"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1048 Wildwood Centre Dr",
            "address_purpose": "LOCATION",
            "city": "Columbia",
            "state": "SC",
            "postal_code": "292298420",
            "country_code": "US",
            "telephone_number": "803-999-3752",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "TRACY",
        "first_name": "SARAH",
        "middle_name": "C.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-01-12",
        "last_updated": "2022-03-30",
        "certification_date": "2022-03-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106S00000X",
            "taxonomy_group": "",
            "desc": "Behavior Technician",
            "state": "SC",
            "license": "17-32737",
            "primary": false
        },
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "SC",
            "license": "7345",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lexington, SC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 30, 2022; 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.