Individual provider Active NPI

Tracy Nelson

  • Counselor
  • Yukon, OK
National Provider Identifier
1710134473
Registry record updated Oct 18, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
CounselorTaxonomy code 101Y00000X
Practice address
508 W Vandament Ave Ste 210
Yukon, OK 73099-4666
Phone
(405) 632-6688
NPI assigned
Aug 25, 2008
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 18, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Counselor 101Y00000X OK Primary

Addresses

Primary practice location

508 W Vandament Ave Ste 210
Yukon, OK 73099-4666

Mailing address

3000 N Grand Blvd
Oklahoma City, OK 73107-1818
Phone (405) 632-6688

Other practice location 1

4000 W Reno Ave
Oklahoma City, OK 73107-6632
Phone (405) 632-6688

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OK
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240117001798 OK Practitioner - Mental Health Counselor 0042660961 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Undefined Non-Physician Type (Specify)
Education
Other, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Variety Care, Inc.Group PAC ID 1557260007, 101 clinicians

Practice addresses (Care Compare)

3000 N Grand Blvd
Oklahoma City, OK 73107-1818
Phone (405) 632-6688

4000 W Reno Ave
Oklahoma City, OK 73107-6632
Phone (405) 632-6688

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Variety Care, Inc. CurrentSince Jan 1, 2024 Accepting new patients
Variety Care, Inc. Current Accepting new patients
Variety Care, Inc. CurrentSince Jan 1, 2024 Accepting new patients
Concepts in Counseling, LLC Past Accepting new patients

Locations

3000 N Grand Blvd
Oklahoma City, OK 73107
Phone 405632668810209

4000 W Reno Ave
Oklahoma City, OK 73107

508 W Vandament Ave
Ste 210
Yukon, OK 73099
Phone (405) 350-0200

Interoperability endpoints

  • Direct secure messaging: tnelson376561@direct.ochin.org

Organizations & group practices 4

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": "1219622400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1634515200000",
    "number": "1710134473",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3000 N GRAND BLVD",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "731071818",
            "telephone_number": "405-632-6688"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "508 W VANDAMENT AVE STE 210",
            "city": "YUKON",
            "state": "OK",
            "postal_code": "730994666",
            "telephone_number": "405-632-6688"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4000 W Reno Ave",
            "address_purpose": "LOCATION",
            "city": "Oklahoma City",
            "state": "OK",
            "postal_code": "731076632",
            "country_code": "US",
            "telephone_number": "405-632-6688",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "NELSON",
        "first_name": "TRACY",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-08-25",
        "last_updated": "2021-10-18",
        "certification_date": "2021-10-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": "OK",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Yukon, OK

Sources for this page

Verify at the official NPI Registry.