Individual provider Active NPI

Tracie K Wecker

  • Addiction (Substance Use Disorder) Registered Nurse
  • Layton, UT
National Provider Identifier
1497439178
Registry record updated Jun 13, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Addiction (Substance Use Disorder) Registered NurseTaxonomy code 163WA0400X
License
211810-3102 Issued in UT
Practice address
523 Heritage Park Blvd Ste 4
Layton, UT 84041-5611
Phone
(801) 525-9998
NPI assigned
Jun 13, 2023
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 13, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) Registered Nurse 163WA0400X 211810-3102 UT Primary

Addresses

Primary practice location

523 Heritage Park Blvd Ste 4
Layton, UT 84041-5611

Mailing address

523 Heritage Park Blvd Ste 4
Layton, UT 84041-5611
Phone (801) 525-9998

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
211810-3102UTMDAddiction (Substance Use Disorder) Registered Nurse

NPI Registry JSON

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

{
    "created_epoch": "1686614400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1686614400000",
    "number": "1497439178",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "523 HERITAGE PARK BLVD STE 4",
            "city": "LAYTON",
            "state": "UT",
            "postal_code": "840415611",
            "telephone_number": "801-525-9998"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "523 HERITAGE PARK BLVD STE 4",
            "city": "LAYTON",
            "state": "UT",
            "postal_code": "840415611",
            "telephone_number": "801-525-9998"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WECKER",
        "first_name": "TRACIE",
        "middle_name": "K",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-06-13",
        "last_updated": "2023-06-13",
        "certification_date": "2023-06-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WA0400X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Addiction (Substance Use Disorder)",
            "state": "UT",
            "license": "211810-3102",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Layton, UT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 13, 2023; 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.