Tracy Ellen Fennemore, REGISTERED DIETITIAN

Primary specialty

Registered DietitianTaxonomy code 133V00000X

License

DN0000272 Issued in DE

Practice address

399 Scarlet Cir
Dover, DE 19904-5658

Phone

(302) 264-9790

NPI assigned

Feb 15, 2019

Last updated

Feb 15, 2019By 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

• Tray Harper Fennemore Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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.

• Christiana Care Health Services, Inc

  dba CCHS Satellite Offices

  • Family Medicine Physician
  • Hockessin, DE
  • NPI 1134104565
  NPD (past)

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

{
    "created_epoch": "1550188800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1550188800000",
    "number": "1548726417",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "399 SCARLET CIR",
            "city": "DOVER",
            "state": "DE",
            "postal_code": "199045658",
            "telephone_number": "302-264-9790"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "399 SCARLET CIR",
            "city": "DOVER",
            "state": "DE",
            "postal_code": "199045658",
            "telephone_number": "302-264-9790"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FENNEMORE",
        "first_name": "TRACY",
        "middle_name": "ELLEN",
        "credential": "REGISTERED DIETITIAN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-02-15",
        "last_updated": "2019-02-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "DE",
            "license": "DN0000272",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "TRAY",
            "last_name": "FENNEMORE",
            "middle_name": "HARPER",
            "credential": "REGISTERED DIETITIAN",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Daniel James Fay, DMD
• Paul A Fedalen, MD
• Carol Feinour, CRNA
• Feldcare Industries LLC (FeldCare Connects)
• Fellowship Health Resources, Inc (Elwyn Adult Behavioral Health Services)
• Annmarie Fenton-Kowrach, NP-C
• Jordan Dana Fernekees, CF-SLP
• Brandt J Feuerstein, MD
• Sara Fields
• Tiffany Fields, LCSW

• Registered Dietitian in Dover, DE
• Providers in Dover, DE by specialty
• Registered Dietitian in Delaware

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 15, 2019; 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.