Individual provider Active NPI

Sharell Elaine Tracy, D.C.

  • Chiropractor
  • Eugene, OR
National Provider Identifier
1609941640
Registry record updated Jul 1, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
1175 Issued in OR
Practice address
1000 River Rd
Eugene, OR 97404-3230
Phone
(541) 689-0935
Fax
(541) 461-6884
NPI assigned
Nov 22, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 1, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 1175 OR Primary

Addresses

Primary practice location

1000 River Rd
Eugene, OR 97404-3230

Mailing address

1000 River Rd
Eugene, OR 97404-3230
Phone (541) 689-0935

Other identifiers 1

IdentifierTypeStateIssuer
009726001OtherORREGENCE BCBS

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OR

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20060119000606 OR Practitioner - Chiropractic 3173547973 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
1175ORMDPsychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Tracy & Keim Chiropractic,LLC Chiropractor CurrentSince Jan 1, 2008 Accepting new patients

Locations

1000 River Rd
Eugene, OR 97404
Phone (541) 689-0395

59 Santa Clara Ave
Eugene, OR 97404
Phone (541) 689-0935

Organizations & group practices 1

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

NPI Registry JSON

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

{
    "created_epoch": "1164153600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1372636800000",
    "number": "1609941640",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1000 RIVER RD",
            "city": "EUGENE",
            "state": "OR",
            "postal_code": "974043230",
            "telephone_number": "541-689-0935",
            "fax_number": "541-461-6884"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1000 RIVER RD",
            "city": "EUGENE",
            "state": "OR",
            "postal_code": "974043230",
            "telephone_number": "541-689-0935",
            "fax_number": "541-461-6884"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TRACY",
        "first_name": "SHARELL",
        "middle_name": "ELAINE",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-11-22",
        "last_updated": "2013-07-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "OR",
            "license": "1175",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "REGENCE BCBS",
            "identifier": "009726001",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Eugene, OR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 1, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.