Individual provider Active NPI

Tracy Bostic Clingan

  • Home Health Registered Respiratory Therapist
  • Hamilton, AL
National Provider Identifier
1710149000
Registry record updated Jun 27, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Home Health Registered Respiratory TherapistTaxonomy code 2279H0200X
License
9359006805 Issued in AL
Practice address
620 Grandview Dr
Hamilton, AL 35570-4332
Phone
(205) 495-4314
NPI assigned
Jun 27, 2008
Last updated
Jun 27, 2008By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 27, 2008

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Home Health Registered Respiratory Therapist 2279H0200X 9359006805 AL Primary
Pulmonary Diagnostics Registered Respiratory Therapist 2279P1004X 9359006805 AL
Cardiology Technician 246W00000X 9359006805 AL

Addresses

Primary practice location

620 Grandview Dr
Hamilton, AL 35570-4332

Mailing address

PO Box 1941
Hamilton, AL 35570-1941
Phone (205) 921-7172

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
9359006805ALMDHome Health Registered Respiratory Therapist

NPI Registry JSON

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

{
    "created_epoch": "1214524800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1214524800000",
    "number": "1710149000",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1941",
            "city": "HAMILTON",
            "state": "AL",
            "postal_code": "355701941",
            "telephone_number": "205-921-7172"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "620 GRANDVIEW DR",
            "city": "HAMILTON",
            "state": "AL",
            "postal_code": "355704332",
            "telephone_number": "205-495-4314"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOSTIC CLINGAN",
        "first_name": "TRACY",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-06-27",
        "last_updated": "2008-06-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2279H0200X",
            "taxonomy_group": "",
            "desc": "Respiratory Therapist, Registered, Home Health",
            "state": "AL",
            "license": "9359006805",
            "primary": true
        },
        {
            "code": "2279P1004X",
            "taxonomy_group": "",
            "desc": "Respiratory Therapist, Registered, Pulmonary Diagnostics",
            "state": "AL",
            "license": "9359006805",
            "primary": false
        },
        {
            "code": "246W00000X",
            "taxonomy_group": "",
            "desc": "Technician, Cardiology",
            "state": "AL",
            "license": "9359006805",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hamilton, AL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 27, 2008; 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.