Tracy Ganem, MS, RDN, CSOWM, LD

Primary specialty

Obesity and Weight Management Nutrition Registered DietitianTaxonomy code 133VN1201X

License

1175 Issued in AL

Practice address

4704 Whitesburg Dr SW Ste 200
Huntsville, AL 35802-1681

Phone

(256) 880-4510

NPI assigned

Oct 20, 2023

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Tracy Ganem Roberts Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Science

Practice roles

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.

• Fay Nutrition

  • Registered Dietitian
  • San Francisco, CA
  • NPI 1104334465
  NPD (past)

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

{
    "created_epoch": "1697760000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1697760000000",
    "number": "1851173017",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1318 AROLEN DR SE",
            "city": "HUNTSVILLE",
            "state": "AL",
            "postal_code": "358032627",
            "telephone_number": "256-479-3925"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4704 WHITESBURG DR SW STE 200",
            "city": "HUNTSVILLE",
            "state": "AL",
            "postal_code": "358021681",
            "telephone_number": "256-880-4510"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GANEM",
        "first_name": "TRACY",
        "credential": "MS, RDN, CSOWM, LD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-10-20",
        "last_updated": "2023-10-20",
        "certification_date": "2023-10-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133VN1201X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered, Nutrition, Obesity and Weight Management",
            "state": "AL",
            "license": "1175",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "TRACY",
            "last_name": "ROBERTS",
            "middle_name": "GANEM",
            "credential": "MS, RDN, CSOWM, LD",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

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• Obesity and Weight Management Nutrition Registered Dietitian in Huntsville, AL
• Providers in Huntsville, AL by specialty
• Obesity and Weight Management Nutrition Registered Dietitian in Alabama

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 20, 2023; 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.