Individual provider Active NPI

Tracy Chapman

  • Pediatrics Physician
  • Winter Park, FL
National Provider Identifier
1700174000
Registry record updated Jan 28, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
OS12891 Issued in FL
Practice address
200 N Lakemont Ave
Pediatric Inpt Care at Winter Park
Winter Park, FL 32792-3273
Phone
(407) 303-2528
Fax
(407) 303-2760
NPI assigned
Jul 20, 2011
Last updated
Jan 28, 2016By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 28, 2016

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 5101019501 MI
Pediatrics Physician 208000000X OS12891 FL Primary

Addresses

Primary practice location

200 N Lakemont Ave
Pediatric Inpt Care at Winter Park
Winter Park, FL 32792-3273

Mailing address

2501 N Orange Ave Ste 446
Orlando, FL 32804-4644
Phone (407) 303-2528

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20160331000596 FL Practitioner - Pediatric Medicine 2567769805 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

State licenses

LicenseStateTypeSpecialty
5101019501MIMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Florida Hospital Medical Group Inc Pediatrics CurrentSince Mar 21, 2016 Accepting new patients
Florida Hospital Medical Group Inc CurrentSince Mar 21, 2016 Accepting new patients

Locations

2600 Westhall Ln
Ste 4
Maitland, FL 32751
Phone (407) 200-2700

2501 N Orange Ave
Ste 446
Orlando, FL 32804
Phone (407) 975-0412

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1311120000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1453939200000",
    "number": "1700174000",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2501 N ORANGE AVE STE 446",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328044644",
            "telephone_number": "407-303-2528",
            "fax_number": "407-303-2760"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 N LAKEMONT AVE",
            "address_2": "PEDIATRIC INPT CARE AT WINTER PARK",
            "city": "WINTER PARK",
            "state": "FL",
            "postal_code": "327923273",
            "telephone_number": "407-303-2528",
            "fax_number": "407-303-2760"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHAPMAN",
        "first_name": "TRACY",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-07-20",
        "last_updated": "2016-01-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "MI",
            "license": "5101019501",
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "FL",
            "license": "OS12891",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Winter Park, FL

Sources for this page

Verify at the official NPI Registry.