Tracy Stover Stam, RDN

Primary specialty

Pediatric Nutrition Registered DietitianTaxonomy code 133VN1004X

License

819174

Practice address

11120 Tamarron PL
Parker, CO 80138-3116

Phone

(303) 717-4391

NPI assigned

Oct 13, 2015

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other names 1

• Mrs. Tracy S. Stam Professional name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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

{
    "created_epoch": "1444694400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1444694400000",
    "number": "1477924678",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11120 TAMARRON PL",
            "city": "PARKER",
            "state": "CO",
            "postal_code": "801383116",
            "telephone_number": "303-717-4391"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11120 TAMARRON PL",
            "city": "PARKER",
            "state": "CO",
            "postal_code": "801383116",
            "telephone_number": "303-717-4391"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STAM",
        "first_name": "TRACY",
        "middle_name": "STOVER",
        "name_prefix": "Mrs.",
        "credential": "RDN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-10-13",
        "last_updated": "2015-10-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133VN1004X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered, Nutrition, Pediatric",
            "state": null,
            "license": "819174",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "TRACY",
            "last_name": "STAM",
            "middle_name": "S.",
            "prefix": "MRS.",
            "credential": "RDN",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

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• Amber Kathleen St.Germain
• Aldona W Staar-Kumosa, MD
• Marta L Stamwitz, LCSW
• Rosario Stanczak, RN
• Brian Burt Stanga, MD
• Borislav Stankov
• Scott Kenneth Stanley, M.D.

• Pediatric Nutrition Registered Dietitian in Parker, CO
• Providers in Parker, CO by specialty
• Pediatric Nutrition Registered Dietitian in Colorado

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 13, 2015; 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.