Individual provider Active NPI

Traci Lynn Veach, NP

  • Adult Health Nurse Practitioner
  • Cleveland, OH
National Provider Identifier
1548325913
Registry record updated Dec 6, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Health Nurse PractitionerTaxonomy code 363LA2200X
License
NP-08661 Issued in OH
Practice address
1730 W 25TH St Ste 1200
Cleveland, OH 44113-3108
Phone
(216) 363-2207
Fax
(216) 363-2237
NPI assigned
Dec 26, 2006
Last updated
Dec 6, 2021By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 6, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X APRN.CNP.08661 OH
Adult Health Nurse Practitioner 363LA2200X NP-08661 OH Primary

Addresses

Primary practice location

1730 W 25TH St Ste 1200
Cleveland, OH 44113-3108

Mailing address

1730 W 25TH St Ste 1200
Cleveland, OH 44113-3108
Phone (216) 363-2207

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20070612000366 OH Practitioner - Nurse Practitioner 2062510233 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2005
Medicare assignment
May accept Medicare assignment
Group practices
Comprehensive Primary CareGroup PAC ID 2860769478, 7 clinicians

Practice addresses (Care Compare)

1730 W 25TH St
Suite 1200
Cleveland, OH 44113-3108
Phone (216) 363-2207

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
NP-08661OHMDAdult Health Nurse Practitioner
APRN.CNP.08661OHMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Renaissance Counseling Service Inc. CurrentSince Oct 15, 2021 Accepting new patients
Infinity Health Care, LLC PastSince Jul 1, 2015 Accepting new patients

Locations

1730 W 25th St
Ste 1200
Cleveland, OH 44113
Phone (216) 363-2207

2351 E 22nd St
Cleveland, OH 44115
Phone (216) 363-2536

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1167091200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1638748800000",
    "number": "1548325913",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1730 W 25TH ST STE 1200",
            "city": "CLEVELAND",
            "state": "OH",
            "postal_code": "441133108",
            "telephone_number": "216-363-2207",
            "fax_number": "216-363-2237"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1730 W 25TH ST STE 1200",
            "city": "CLEVELAND",
            "state": "OH",
            "postal_code": "441133108",
            "telephone_number": "216-363-2207",
            "fax_number": "216-363-2237"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VEACH",
        "first_name": "TRACI",
        "middle_name": "LYNN",
        "name_prefix": "Ms.",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-12-26",
        "last_updated": "2021-12-06",
        "certification_date": "2021-12-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "OH",
            "license": "APRN.CNP.08661",
            "primary": false
        },
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "OH",
            "license": "NP-08661",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cleveland, OH

Sources for this page

Verify at the official NPI Registry.