Individual provider Active NPI

Christiana Tracy

  • Occupational Therapy Assistant
  • Colorado Springs, CO
National Provider Identifier
1497367965
Registry record updated Aug 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational Therapy AssistantTaxonomy code 224Z00000X
License
1220 Issued in CO
Practice address
5446 N Academy Blvd Ste 204
Colorado Springs, CO 80918-3669
Phone
(719) 598-5555
Fax
(719) 388-2030
NPI assigned
Aug 17, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 21, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapy Assistant 224Z00000X 1220 CO Primary

Addresses

Primary practice location

5446 N Academy Blvd Ste 204
Colorado Springs, CO 80918-3669

Mailing address

11681 Voyager Pkwy
Colorado Springs, CO 80921-3861
Phone (719) 344-9342

Other practice location 1

11681 Voyager Pkwy
Colorado Springs, CO 80921-3861
Phone (719) 344-9342

Other identifiers 1

IdentifierTypeStateIssuer
NAOtherCONA

Electronic endpoints 3

TypeEndpointUseAffiliation
CONNECT URL ctracy@wholekidsco.com Direct
CONNECT URL ctracy@wholekidsco.com Direct
CONNECT URL ctracy@wholekidsco.com Direct

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

State licenses

LicenseStateTypeSpecialty
1220COMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Wellcare Inc. CurrentSince Aug 28, 2022 Accepting new patients
Nurture Home Health Care Inc PastSince Aug 28, 2022 Accepting new patients

Locations

5446 N Academy Blvd
Ste 204
Colorado Springs, CO 80918
Phone (719) 400-7612

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": "1597622400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1661040000000",
    "number": "1497367965",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11681 VOYAGER PKWY",
            "city": "COLORADO SPRINGS",
            "state": "CO",
            "postal_code": "809213861",
            "telephone_number": "719-344-9342"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5446 N ACADEMY BLVD STE 204",
            "city": "COLORADO SPRINGS",
            "state": "CO",
            "postal_code": "809183669",
            "telephone_number": "719-598-5555",
            "fax_number": "719-388-2030"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "11681 Voyager Pkwy",
            "address_purpose": "LOCATION",
            "city": "Colorado Springs",
            "state": "CO",
            "postal_code": "809213861",
            "country_code": "US",
            "telephone_number": "719-344-9342",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "TRACY",
        "first_name": "CHRISTIANA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-08-17",
        "last_updated": "2022-08-21",
        "certification_date": "2022-08-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "224Z00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapy Assistant",
            "state": "CO",
            "license": "1220",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NA",
            "identifier": "NA",
            "state": "CO"
        }
    ],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "ctracy@wholekidsco.com",
            "affiliation": "N",
            "endpointDescription": "work email",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "Colorado Springs",
            "address_1": "11681 Voyager Pkwy",
            "city": "Colorado Springs",
            "state": "CO",
            "country_code": "US",
            "postal_code": "809213861",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "ctracy@wholekidsco.com",
            "affiliation": "N",
            "endpointDescription": "work email",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "Colorado Springs",
            "address_1": "11681 Voyager Pkwy",
            "city": "Colorado Springs",
            "state": "CO",
            "country_code": "US",
            "postal_code": "809213861",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "ctracy@wholekidsco.com",
            "affiliation": "N",
            "endpointDescription": "work email",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "Colorado Springs",
            "address_1": "11681 Voyager Pkwy",
            "city": "Colorado Springs",
            "state": "CO",
            "country_code": "US",
            "postal_code": "809213861",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Colorado Springs, CO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 21, 2022; 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.