Individual provider Active NPI

Trayce D Fitzpatrick

  • Peer Specialist
  • Beachwood, OH
National Provider Identifier
1659039576
Registry record updated Dec 8, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Peer SpecialistTaxonomy code 175T00000X
License
0002592 Issued in OH
Practice address
25201 Chagrin Blvd Ste 390
Beachwood, OH 44122-5637
Phone
(216) 910-9015
Fax
(216) 910-9015
NPI assigned
Dec 8, 2021
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 8, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Peer SpecialistGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 175T00000X 0002592 OH Primary

Addresses

Primary practice location

25201 Chagrin Blvd Ste 390
Beachwood, OH 44122-5637

Mailing address

483 E 112TH St
Cleveland, OH 44108-1446
Phone (216) 278-6768

Other names 1

  • Ms. Tracey D Fitzpatrick Former name

Electronic endpoints 1

TypeEndpointUseAffiliation
CONNECT URL www.peopleplacesanddreams.com Direct People Places and Dreams LLC

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
0002592OHMDPeer Specialist

NPI Registry JSON

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

{
    "created_epoch": "1638921600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1638921600000",
    "number": "1659039576",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "483 E 112TH ST",
            "city": "CLEVELAND",
            "state": "OH",
            "postal_code": "441081446",
            "telephone_number": "216-278-6768"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "25201 CHAGRIN BLVD STE 390",
            "city": "BEACHWOOD",
            "state": "OH",
            "postal_code": "441225637",
            "telephone_number": "216-910-9015",
            "fax_number": "216-910-9015"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FITZPATRICK",
        "first_name": "TRAYCE",
        "middle_name": "D",
        "name_prefix": "Ms.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-12-08",
        "last_updated": "2021-12-08",
        "certification_date": "2021-12-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "175T00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Peer Specialist",
            "state": "OH",
            "license": "0002592",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "www.peopleplacesanddreams.com",
            "affiliation": "Y",
            "endpointDescription": "company website",
            "affiliationName": "People Places and Dreams LLC",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "3214 Prospect Ave E",
            "city": "Cleveland",
            "state": "OH",
            "country_code": "US",
            "postal_code": "441152614",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "TRACEY",
            "last_name": "FITZPATRICK",
            "middle_name": "D",
            "prefix": "MS.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Beachwood, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 8, 2021; 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.