Individual provider Active NPI

Tracie Lynn Hammer, MSW

  • Social Worker
  • Middletown, NY
National Provider Identifier
1811628753
Registry record updated Jun 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Social WorkerTaxonomy code 104100000X
License
115782-01 Issued in NY
Practice address
15 Fortune Rd W
Middletown, NY 10941-1625
Phone
(845) 421-6337
Fax
(845) 341-0226
NPI assigned
Jun 21, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 21, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Social Worker 104100000X 115782-01 NY Primary

Addresses

Primary practice location

15 Fortune Rd W
Middletown, NY 10941-1625

Mailing address

15 Fortune Rd W
Middletown, NY 10941-1625
Phone (845) 421-6337

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
115782-01NYMDSocial Worker

NPI Registry JSON

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

{
    "created_epoch": "1655769600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1655769600000",
    "number": "1811628753",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15 FORTUNE RD W",
            "city": "MIDDLETOWN",
            "state": "NY",
            "postal_code": "109411625",
            "telephone_number": "845-421-6337",
            "fax_number": "845-341-0226"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15 FORTUNE RD W",
            "city": "MIDDLETOWN",
            "state": "NY",
            "postal_code": "109411625",
            "telephone_number": "845-421-6337",
            "fax_number": "845-341-0226"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HAMMER",
        "first_name": "TRACIE",
        "middle_name": "LYNN",
        "name_prefix": "Ms.",
        "credential": "MSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-06-21",
        "last_updated": "2022-06-21",
        "certification_date": "2022-06-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "NY",
            "license": "115782-01",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Middletown, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 21, 2022; 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.