Individual provider Active NPI

William Tracy Mock, RN, MSN

  • Medical-Surgical Registered Nurse
  • Orlando, FL
National Provider Identifier
1871721936
Registry record updated Jun 29, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical-Surgical Registered NurseTaxonomy code 163WM0705X
License
RN1472152 Issued in FL
Practice address
5201 Raymond St
Orlando VA Medical Center
Orlando, FL 32803
Phone
(407) 599-1543
NPI assigned
Jun 29, 2009
Last updated
Jun 29, 2009By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 29, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medical-Surgical Registered Nurse 163WM0705X RN1472152 FL Primary

Addresses

Primary practice location

5201 Raymond St
Orlando VA Medical Center
Orlando, FL 32803

Mailing address

1237 Killarney Dr
Ormond Beach, FL 32174-2828
Phone (386) 492-6024

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
Credentials
Master of Science - Nursing, Registered Nurse

State licenses

LicenseStateTypeSpecialty
RN1472152FLMDMedical-Surgical Registered Nurse

NPI Registry JSON

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

{
    "created_epoch": "1246233600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1246233600000",
    "number": "1871721936",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1237 KILLARNEY DR",
            "city": "ORMOND BEACH",
            "state": "FL",
            "postal_code": "321742828",
            "telephone_number": "386-492-6024"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5201 RAYMOND ST",
            "address_2": "ORLANDO VA MEDICAL CENTER",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "32803",
            "telephone_number": "407-599-1543"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOCK",
        "first_name": "WILLIAM",
        "middle_name": "TRACY",
        "credential": "RN, MSN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-06-29",
        "last_updated": "2009-06-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WM0705X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Medical-Surgical",
            "state": "FL",
            "license": "RN1472152",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Orlando, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 29, 2009; 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.