Individual provider Active NPI

Tracy Jo Vincent, DPT

  • Physical Therapist
  • Merriam, KS
National Provider Identifier
1891069167
Registry record updated Jan 29, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
P13567 Issued in NC
Practice address
10000 W 75TH St
Suite 250
Merriam, KS 66204-2209
Phone
(913) 894-1910
Fax
(877) 913-1174
NPI assigned
Mar 2, 2012
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 29, 2013

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X P13567 NC Primary
Pediatric Physical Therapist 2251P0200X P13567 NC

Addresses

Primary practice location

10000 W 75TH St
Suite 250
Merriam, KS 66204-2209

Mailing address

10000 W 75TH St
Suite 250
Merriam, KS 66204-2209
Phone (913) 894-1910

Other identifiers 1

IdentifierTypeStateIssuer
7212990MedicaidNC

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
P13567NCMDPediatric Physical Therapist

NPI Registry JSON

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

{
    "created_epoch": "1330646400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1359417600000",
    "number": "1891069167",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10000 W 75TH ST",
            "address_2": "SUITE 250",
            "city": "MERRIAM",
            "state": "KS",
            "postal_code": "662042209",
            "telephone_number": "913-894-1910",
            "fax_number": "877-913-1174"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10000 W 75TH ST",
            "address_2": "SUITE 250",
            "city": "MERRIAM",
            "state": "KS",
            "postal_code": "662042209",
            "telephone_number": "913-894-1910",
            "fax_number": "877-913-1174"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VINCENT",
        "first_name": "TRACY",
        "middle_name": "JO",
        "name_prefix": "Dr.",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-03-02",
        "last_updated": "2013-01-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NC",
            "license": "P13567",
            "primary": true
        },
        {
            "code": "2251P0200X",
            "taxonomy_group": "",
            "desc": "Physical Therapist, Pediatrics",
            "state": "NC",
            "license": "P13567",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7212990",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Merriam, KS

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 29, 2013; 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.