Individual provider Active NPI

Elizabeth Catherine Tracy, N.P.

  • Nurse Practitioner
  • Montrose, CO
National Provider Identifier
1528039427
Registry record updated Jan 20, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
APN0991558NP Issued in CO
Practice address
2130 E Main St
Montrose, CO 81401-3834
Phone
(970) 252-3123
Fax
(970) 252-3208
NPI assigned
Jan 30, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 20, 2015

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X APN0991558NP CO Primary
Nurse Practitioner 363L00000X RN0054045 CO
Nurse Practitioner 363L00000X RXN0101115 CO

Addresses

Primary practice location

2130 E Main St
Montrose, CO 81401-3834

Mailing address

2130 E Main St
Montrose, CO 81401-3834
Phone (970) 252-3123

Other identifiers 2

IdentifierTypeStateIssuer
04100095MedicaidCO
22522859MedicaidCO

Other names 1

  • Elizabeth Catherine Siwarski Other name

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
HHS exclusion list flag
Flagged The directory lists this NPI on an HHS exclusion list. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
APN0991558NPCOMDNurse Practitioner
RN0054045COMDNurse Practitioner
RXN0101115COMDNurse Practitioner

NPI Registry JSON

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

{
    "created_epoch": "1138579200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1421712000000",
    "number": "1528039427",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2130 E MAIN ST",
            "city": "MONTROSE",
            "state": "CO",
            "postal_code": "814013834",
            "telephone_number": "970-252-3123",
            "fax_number": "970-252-3208"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2130 E MAIN ST",
            "city": "MONTROSE",
            "state": "CO",
            "postal_code": "814013834",
            "telephone_number": "970-252-3123",
            "fax_number": "970-252-3208"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TRACY",
        "first_name": "ELIZABETH",
        "middle_name": "CATHERINE",
        "credential": "N.P.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-01-30",
        "last_updated": "2015-01-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "CO",
            "license": "APN0991558NP",
            "primary": true
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "CO",
            "license": "RN0054045",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "CO",
            "license": "RXN0101115",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "04100095",
            "state": "CO"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "22522859",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ELIZABETH",
            "last_name": "SIWARSKI",
            "middle_name": "CATHERINE",
            "credential": "N.P.",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Montrose, CO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 20, 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.