Individual provider Active NPI

Jennifer Ozols Tracy, PSY.D.

  • Psychologist
  • Asheville, NC
National Provider Identifier
1780753913
Registry record updated Sep 11, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
Practice address
1 Oak PLZ
Suite 206
Asheville, NC 28801-3008
Phone
(828) 252-2501
Fax
(828) 252-2701
NPI assigned
Nov 6, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 11, 2019

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X 2452 NC
Psychologist 103T00000X Primary

Addresses

Primary practice location

1 Oak PLZ
Suite 206
Asheville, NC 28801-3008

Mailing address

1 Oak PLZ Ste 208
Asheville, NC 28801-3000
Phone (828) 575-9760

Other identifiers 2

IdentifierTypeStateIssuer
6000038MedicaidNC
129XMOtherNCBCBS

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC
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
I20141107000720 NC Practitioner - Clinical Psychologist 6608098660 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 1997
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Appalachian Counseling and Psychological Services IncGroup PAC ID 4880996792, 27 clinicians

Practice addresses (Care Compare)

1 Oak PLZ
Suite 208
Asheville, NC 28801-3000
Phone (828) 575-9760

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2452NCMDMental Health Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Appalachian Counseling and Psychological Services Psychologist CurrentSince Dec 16, 2020 Accepting new patients
Appalachian Counseling and Psychological Services, Inc. Psychologist CurrentSince Aug 26, 2019 Accepting new patients

Locations

1 Oak Plz
Ste 208
Asheville, NC 28801
Phone (828) 575-9760

1 Oak Plz
Ste 206
Asheville, NC 28801
Phone (828) 252-2501

600A Centrepark Dr
Asheville, NC 28805
Phone (828) 575-9760

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1162771200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1568160000000",
    "number": "1780753913",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 OAK PLZ STE 208",
            "city": "ASHEVILLE",
            "state": "NC",
            "postal_code": "288013000",
            "telephone_number": "828-575-9760",
            "fax_number": "828-575-9761"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 OAK PLZ",
            "address_2": "SUITE 206",
            "city": "ASHEVILLE",
            "state": "NC",
            "postal_code": "288013008",
            "telephone_number": "828-252-2501",
            "fax_number": "828-252-2701"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TRACY",
        "first_name": "JENNIFER",
        "middle_name": "OZOLS",
        "credential": "PSY.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-11-06",
        "last_updated": "2019-09-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "NC",
            "license": "2452",
            "primary": false
        },
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "6000038",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "129XM",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Asheville, NC

Sources for this page

Verify at the official NPI Registry.