Tracy Ann Mooney Wynder, RN

Primary specialty

Home Health Registered NurseTaxonomy code 163WH0200X

License

RN526993L Issued in PA

Practice address

207 Everhart St
Dupont, PA 18641-2107

Phone

(570) 262-8534

NPI assigned

Sep 8, 2010

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 3

Addresses

Other identifiers 2

Other names 1

• Mrs. Tracy Ann Mooney Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Registered Nurse

State licenses

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

{
    "created_epoch": "1283904000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1283904000000",
    "number": "1770890006",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "207 EVERHART ST",
            "city": "DUPONT",
            "state": "PA",
            "postal_code": "186412107",
            "telephone_number": "570-262-8534"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "207 EVERHART ST",
            "city": "DUPONT",
            "state": "PA",
            "postal_code": "186412107",
            "telephone_number": "570-262-8534"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOONEY WYNDER",
        "first_name": "TRACY",
        "middle_name": "ANN",
        "name_prefix": "Mrs.",
        "credential": "RN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2010-09-08",
        "last_updated": "2010-09-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "PA",
            "license": "RN526993L",
            "primary": false
        },
        {
            "code": "163WH0200X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Home Health",
            "state": "PA",
            "license": "RN526993L",
            "primary": true
        },
        {
            "code": "163WW0000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Wound Care",
            "state": "PA",
            "license": "RN526993L",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RN",
            "identifier": "RN526993L",
            "state": "PA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "RN526993L",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "TRACY",
            "last_name": "MOONEY",
            "middle_name": "ANN",
            "prefix": "MRS.",
            "credential": "RN",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Brian Shawn Jones, PT
• Brianna Ketcho, PTA
• John P Konicki, DDS
• Peter X Konicki, RPH
• Catherine M Madsen, RD
• Tyler James Motisko, DC
• Paul M Rutkowski DO PC
• Redicka Pharmacy
• Paul Michael Rutkowski, D.O.
• Kathleen Sudol, MS OTR/L

• Home Health Registered Nurse in Dupont, PA
• Providers in Dupont, PA by specialty
• Home Health Registered Nurse in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 8, 2010; 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.