Tracie Kathryn Myers, TM

Primary specialty

MidwifeTaxonomy code 176B00000X

Practice address

22976 Quamba St
Brook Park, MN 55007-4674

Phone

(763) 691-3746

Fax

(320) 679-7045

NPI assigned

Feb 1, 2011

Last updated

Apr 20, 2011By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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

{
    "created_epoch": "1296518400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1303257600000",
    "number": "1750687208",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "22976 QUAMBA ST",
            "city": "BROOK PARK",
            "state": "MN",
            "postal_code": "550074674",
            "telephone_number": "763-691-3746",
            "fax_number": "320-679-7045"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "22976 QUAMBA ST",
            "city": "BROOK PARK",
            "state": "MN",
            "postal_code": "550074674",
            "telephone_number": "763-691-3746",
            "fax_number": "320-679-7045"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MYERS",
        "first_name": "TRACIE",
        "middle_name": "KATHRYN",
        "credential": "TM",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2011-02-01",
        "last_updated": "2011-04-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "176B00000X",
            "taxonomy_group": "",
            "desc": "Midwife",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Midwife in Brook Park, MN
• Providers in Brook Park, MN by specialty
• Midwife in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 20, 2011; 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.