Active NPI
Tracy Cannady, MA/CAS, LPA
- Psychologist
- Durham, NC
National Provider Identifier
1457792830
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychologist
- License
- 3734
- Practice address
- 3308 Durham Chapel Hill Blvd Ste F
Durham, NC 27707-6200 - Phone
- (919) 559-5022
- NPI assigned
- Jul 12, 2013
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Intellectual & Developmental Disabilities Psychologist | 103TM1800X | |||
| Psychologist | 103T00000X | 3734 | NC | Primary |
| School Psychologist | 103TS0200X |
Addresses
Primary practice location
3308 Durham Chapel Hill Blvd Ste F
Durham, NC 27707-6200
Mailing address
6220 San Marcos Way
Raleigh, NC 27616-8447
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Master of Arts
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 3734 | NC | MD | Speech-Language Pathologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1373587200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1373587200000",
"number": "1457792830",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "6220 SAN MARCOS WAY",
"city": "RALEIGH",
"state": "NC",
"postal_code": "276168447"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3308 DURHAM CHAPEL HILL BLVD STE F",
"city": "DURHAM",
"state": "NC",
"postal_code": "277076200",
"telephone_number": "919-559-5022"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CANNADY",
"first_name": "TRACY",
"name_prefix": "Ms.",
"credential": "MA/CAS, LPA",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2013-07-12",
"last_updated": "2013-07-12",
"status": "A"
},
"taxonomies": [
{
"code": "103TM1800X",
"taxonomy_group": "",
"desc": "Psychologist, Intellectual & Developmental Disabilities",
"state": null,
"license": null,
"primary": false
},
{
"code": "103T00000X",
"taxonomy_group": "",
"desc": "Psychologist",
"state": "NC",
"license": "3734",
"primary": true
},
{
"code": "103TS0200X",
"taxonomy_group": "",
"desc": "Psychologist, School",
"state": null,
"license": null,
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Durham, NC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 12, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.