Tracy J Shore, MSN,APN,CPNP

Primary specialty

Pediatric Nurse PractitionerTaxonomy code 363LP0200X

License

26NJ00022800 Issued in NJ

Practice address

132 Franklin Corner Rd
Lawrenceville, NJ 08648-2523

Phone

(609) 896-3808

NPI assigned

Jan 30, 2007

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Certified Pediatric Nurse Practitioner, Master of Science - Nursing, Nurse Practitioner

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Delaware Valley Pediatric Associates, PA

  • Pediatrics Physician
  • Lawrenceville, NJ
  • NPI 1396782256
  NPD (past)

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

{
    "created_epoch": "1170115200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1553126400000",
    "number": "1477699965",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "166 FAIRVIEW RD",
            "city": "SKILLMAN",
            "state": "NJ",
            "postal_code": "085581513",
            "telephone_number": "609-712-8200"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "132 FRANKLIN CORNER RD",
            "city": "LAWRENCEVILLE",
            "state": "NJ",
            "postal_code": "086482523",
            "telephone_number": "609-896-3808"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHORE",
        "first_name": "TRACY",
        "middle_name": "J",
        "name_prefix": "Mrs.",
        "credential": "MSN,APN,CPNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-01-30",
        "last_updated": "2019-03-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "NJ",
            "license": "NJ000228",
            "primary": false
        },
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "NJ",
            "license": "26NJ00022800",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "tracy@dvpa.pcc.com",
            "affiliation": "N",
            "endpointDescription": "direct email address",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "132 Franklin Corner Rd",
            "city": "Lawrenceville",
            "state": "NJ",
            "country_code": "US",
            "postal_code": "086482523",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Brandi Shaw, LSW, LCADC
• Sheldon S. Berkman, D.M.D., P.a.
• Sheldon S. Berkman, DMD, PA
• John Joseph Shelmet, MD
• Serena Shipe, HAS
• Ajay K Shukla, PHARMD
• Mahmood Islam Siddique, D.O.
• Sara Siddiqui
• Silver Pharma (Silver Pharmacy)
• Silver Pharma LLC (Silver Pharmacy)

• Pediatric Nurse Practitioner in Lawrenceville, NJ
• Providers in Lawrenceville, NJ by specialty
• Pediatric Nurse Practitioner in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 21, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.