Individual provider Active NPI

Tracey Earnette Powell, DNP

  • Military Hospital
  • Monterey, CA
National Provider Identifier
1588853816
Registry record updated Jul 31, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Military HospitalTaxonomy code 286500000X
License
RN284714APRNCNP10013 Issued in OH
Practice address
473 Cabrillo St # B422
Monterey, CA 93944-3201
Phone
(831) 242-4328
NPI assigned
Oct 23, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 31, 2019

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X RN284714 OH
Psychiatric/Mental Health Clinical Nurse Specialist 364SP0808X RN284714 OH
Military Hospital 286500000X RN284714APRNCNP10013 OH Primary

Addresses

Primary practice location

473 Cabrillo St # B422
Monterey, CA 93944-3201

Mailing address

1135 3Rd St
Monterey, CA 93940-3333
Phone (614) 565-8939

Other practice location 1

1 Jarrett White Rd
Tripler Army Medical Center ATTN: MCHK-QS
Tripler Amc, HI 96859-5001
Phone (808) 433-2460

Other practice location 2

9040 Jackson Ave Attn: Credentials Office
Tacoma, WA 98431-3201
Phone (253) 968-1290

Other identifiers 1

IdentifierTypeStateIssuer
1588853816OtherNPI #

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

LicenseStateTypeSpecialty
RN284714APRNCNP10013OHMDMilitary Hospital
RN284714OHMDPsychiatric/Mental Health Clinical Nurse Specialist

NPI Registry JSON

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

{
    "created_epoch": "1193097600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1564531200000",
    "number": "1588853816",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1135 3RD ST",
            "city": "MONTEREY",
            "state": "CA",
            "postal_code": "939403333",
            "telephone_number": "614-565-8939"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "473 CABRILLO ST # B422",
            "city": "MONTEREY",
            "state": "CA",
            "postal_code": "939443201",
            "telephone_number": "831-242-4328"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1 Jarrett White Rd",
            "address_2": "Tripler Army Medical Center ATTN: MCHK-QS",
            "address_purpose": "LOCATION",
            "city": "Tripler Amc",
            "state": "HI",
            "postal_code": "968595001",
            "country_code": "US",
            "telephone_number": "808-433-2460",
            "fax_number": "808-433-1558",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "9040 Jackson Ave Attn: Credentials Office",
            "address_purpose": "LOCATION",
            "city": "Tacoma",
            "state": "WA",
            "postal_code": "984313201",
            "country_code": "US",
            "telephone_number": "253-968-1290",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "POWELL",
        "first_name": "TRACEY",
        "middle_name": "EARNETTE",
        "credential": "DNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-10-23",
        "last_updated": "2019-07-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "OH",
            "license": "RN284714",
            "primary": false
        },
        {
            "code": "364SP0808X",
            "taxonomy_group": "",
            "desc": "Clinical Nurse Specialist, Psychiatric/Mental Health",
            "state": "OH",
            "license": "RN284714",
            "primary": false
        },
        {
            "code": "286500000X",
            "taxonomy_group": "",
            "desc": "Military Hospital",
            "state": "OH",
            "license": "RN284714APRNCNP10013",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI #",
            "identifier": "1588853816",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Monterey, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 31, 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.