Traci Lynn Chupp, MSN, RN, NNP-BC

Primary specialty

Neonatal Nurse PractitionerTaxonomy code 363LN0000X

License

601936 Issued in TX

Practice address

5201 Harry Hines Blvd
Neonatal ICU
Dallas, TX 75235-7708

Phone

(214) 590-8487

NPI assigned

Jan 8, 2008

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in AR

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Nurse Practitioner

Education

Other, 2000

Medicare assignment

May accept Medicare assignment

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Science - Nursing, Nurse Practitioner, Registered Nurse

State licenses

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.

• Springdale- Bentonville HBP Services, LLC

  • Neonatal-Perinatal Medicine Physician
  • Bentonville, AR
  • NPI 1811762701
  Medicare reassignment

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

{
    "created_epoch": "1199750400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1597795200000",
    "number": "1821273939",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 660599",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752660599"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5201 HARRY HINES BLVD",
            "address_2": "NEONATAL ICU",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752357708",
            "telephone_number": "214-590-8487"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "6151 S Yale Ave",
            "address_purpose": "LOCATION",
            "city": "Tulsa",
            "state": "OK",
            "postal_code": "741361907",
            "country_code": "US",
            "telephone_number": "918-502-6097",
            "fax_number": "918-502-6046",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CHUPP",
        "first_name": "TRACI",
        "middle_name": "LYNN",
        "name_prefix": "Mrs.",
        "credential": "MSN, RN, NNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-01-08",
        "last_updated": "2020-08-19",
        "certification_date": "2020-08-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LN0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Neonatal",
            "state": "OK",
            "license": "136981",
            "primary": false
        },
        {
            "code": "363LN0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Neonatal",
            "state": "TX",
            "license": "601936",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Paul Chung, M.D.
• Sei Y Chung, M.D.
• Stephen Shiu-Wah Chung, MD
• Victoria Chung, D.O.
• Wendy Mingyee Chung, M.D.
• Church of the Living God PGT
• Skipper Daniel Church, CRNA
• Churchill Healthcare Education Resources and Outreach
• Christina C Churu, RN
• Lyla Chustz, OTR

• Neonatal Nurse Practitioner in Dallas, TX
• Providers in Dallas, TX by specialty
• Neonatal Nurse Practitioner in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 19, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.