Tracey Lynn Wilcox, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

60413586 Issued in WA

Practice address

5005 Ruston Way
Ste 125
Tacoma, WA 98402-5314

Phone

(253) 759-4522

Fax

(253) 759-4699

NPI assigned

Nov 5, 2005

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

Other identifiers 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

HHS exclusion list flag

Flagged The directory lists this NPI on an HHS exclusion list. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.

Credentials

Physician Assistant

State licenses

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

{
    "created_epoch": "1131148800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1424390400000",
    "number": "1881675015",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5005 RUSTON WAY",
            "address_2": "STE 125",
            "city": "TACOMA",
            "state": "WA",
            "postal_code": "984025314",
            "telephone_number": "253-759-4522",
            "fax_number": "253-759-4699"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5005 RUSTON WAY",
            "address_2": "STE 125",
            "city": "TACOMA",
            "state": "WA",
            "postal_code": "984025314",
            "telephone_number": "253-759-4522",
            "fax_number": "253-759-4699"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILCOX",
        "first_name": "TRACEY",
        "middle_name": "LYNN",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-11-05",
        "last_updated": "2015-02-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "FL",
            "license": "PA9102446",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "WA",
            "license": "60413586",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2916622000",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE L&I",
            "identifier": "336140",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Deanna Majhelle Wilcox, BCAT
• Kennedy H Wilcox
• Mary M. Wilcox, ARNP
• Matthew Cody Wilcox, RN
• Rebekah A Wilcox, RN
• Karen Rose Wild, OTR/L
• Kate Alyca Wild, CPM
• Andrew James Wildasin, LPN
• Monic Lissette Wildasin, PA-C
• Bernice Joann Wilder, DNP, ARNP, BC

• Physician Assistant in Tacoma, WA
• Providers in Tacoma, WA by specialty
• Physician Assistant in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 20, 2015; 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.