Tracie Jennifer Widner, MA, CCC-SLP

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

0000003613 Issued in TN

Practice address

2190 Winfield Dunn Pkwy
Sevierville, TN 37876-0502

Phone

(865) 280-2799

Fax

(865) 366-2384

NPI assigned

Jul 9, 2013

Last updated

Apr 19, 2022By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Miss Tracie Jennifer Barker Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Arts

State licenses

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

{
    "created_epoch": "1373328000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1650326400000",
    "number": "1538500376",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2190 WINFIELD DUNN PKWY",
            "city": "SEVIERVILLE",
            "state": "TN",
            "postal_code": "378760502",
            "telephone_number": "865-280-2799",
            "fax_number": "865-366-2384"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2190 WINFIELD DUNN PKWY",
            "city": "SEVIERVILLE",
            "state": "TN",
            "postal_code": "378760502",
            "telephone_number": "865-280-2799",
            "fax_number": "865-366-2384"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WIDNER",
        "first_name": "TRACIE",
        "middle_name": "JENNIFER",
        "name_prefix": "Mrs.",
        "credential": "MA, CCC-SLP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-07-09",
        "last_updated": "2022-04-19",
        "certification_date": "2022-03-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "TN",
            "license": "0000003613",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "TRACIE",
            "last_name": "BARKER",
            "middle_name": "JENNIFER",
            "prefix": "MISS",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Madison Whaley, MSSW
• Hubert C Wheatley, MD
• Courtney White, LPC-MHSP
• Jill Marie White, LCSW
• Alan L Whiton, M.D.
• Derek Wiggins, PA-C
• Jamie T Williams, OTD, OTR/L
• Phyllis Susan Williams
• Kyle Walker Williamson
• Justin Patrick Willson, DDS

• Speech-Language Pathologist in Sevierville, TN
• Providers in Sevierville, TN by specialty
• Speech-Language Pathologist in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 19, 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.