Individual provider Active NPI

Tracy Jujara

  • Assisted Living Facility
  • Marietta, GA
National Provider Identifier
1528840436
Registry record updated Oct 16, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Assisted Living FacilityTaxonomy code 310400000X
Practice address
3292 Barrett Pkwy NW
Marietta, GA 30064-1872
Phone
(470) 531-5940
NPI assigned
Oct 16, 2023
Last updated
Oct 16, 2023By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 16, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Assisted Living Facility 310400000X NU Primary

Addresses

Primary practice location

3292 Barrett Pkwy NW
Marietta, GA 30064-1872

Mailing address

3292 Ernest W Barrett Pkwy NW
Marietta, GA 30064-1872
Phone (470) 531-5940

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

NPI Registry JSON

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

{
    "created_epoch": "1697414400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1697414400000",
    "number": "1528840436",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3292 ERNEST W BARRETT PKWY NW",
            "city": "MARIETTA",
            "state": "GA",
            "postal_code": "300641872",
            "telephone_number": "470-531-5940"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3292 BARRETT PKWY NW",
            "city": "MARIETTA",
            "state": "GA",
            "postal_code": "300641872",
            "telephone_number": "470-531-5940"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JUJARA",
        "first_name": "TRACY",
        "name_prefix": "Ms.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-10-16",
        "last_updated": "2023-10-16",
        "certification_date": "2023-10-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Marietta, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 16, 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.