Active NPI
Tracy Allison Wilson, LMP
- Specialist
- Reno, NV
National Provider Identifier
1548343205
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Specialist
- License
- MA00020990
- Practice address
- 1000 Bible Way Ste 73
Reno, NV 89502-2134 - Phone
- (775) 292-0610
- NPI assigned
- Oct 23, 2006
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Specialist | 174400000X | MA00020990 | WA | Primary |
Addresses
Primary practice location
1000 Bible Way Ste 73
Reno, NV 89502-2134
Mailing address
10644 Fire Poppy Cir
Reno, NV 89521-6277
Phone (775) 292-0610
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0197543 | Other | WA | WA LABOR & INDUSTRIES |
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
| License | State | Type | Specialty |
|---|---|---|---|
| MA00020990 | WA | MD | Specialist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1161561600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1385337600000",
"number": "1548343205",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "10644 FIRE POPPY CIR",
"city": "RENO",
"state": "NV",
"postal_code": "895216277",
"telephone_number": "775-292-0610",
"fax_number": "775-292-0610"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1000 BIBLE WAY STE 73",
"city": "RENO",
"state": "NV",
"postal_code": "895022134",
"telephone_number": "775-292-0610"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WILSON",
"first_name": "TRACY",
"middle_name": "ALLISON",
"credential": "LMP",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2006-10-23",
"last_updated": "2013-11-25",
"status": "A"
},
"taxonomies": [
{
"code": "174400000X",
"taxonomy_group": "",
"desc": "Specialist",
"state": "WA",
"license": "MA00020990",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "WA LABOR & INDUSTRIES",
"identifier": "0197543",
"state": "WA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Reno, NV
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 25, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.