Organization Active NPI

Tracy S Fansler MD LLC

  • Obstetrics & Gynecology Physician
  • Largo, FL
National Provider Identifier
1902091721
Registry record updated Jan 14, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X
Legal business name
TRACY S FANSLER MD LLC
Practice address
12955 Seminole Blvd
Largo, FL 33778-2399
Phone
(727) 584-9500
Fax
(727) 584-9502
NPI assigned
Sep 14, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 14, 2019

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

Authorized official

Name
Tracy S Fansler, M.D.
Title
President
Phone
(727) 584-9500

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics & Gynecology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207V00000X Primary

Addresses

Primary practice location

12955 Seminole Blvd
Largo, FL 33778-2399

Mailing address

11200 Seminole Blvd Ste 210
Largo, FL 33778-3239
Phone (727) 584-9500

Other identifiers 1

IdentifierTypeStateIssuer
261667000MedicaidFL

National Provider Directory

National Provider Directory

Locations

12955 Seminole Blvd
Seminole, FL 33778
Phone (727) 584-9500

NPI Registry JSON

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

{
    "created_epoch": "1189728000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1547424000000",
    "number": "1902091721",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11200 SEMINOLE BLVD STE 210",
            "city": "LARGO",
            "state": "FL",
            "postal_code": "337783239",
            "telephone_number": "727-584-9500",
            "fax_number": "727-440-9178"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12955 SEMINOLE BLVD",
            "city": "LARGO",
            "state": "FL",
            "postal_code": "337782399",
            "telephone_number": "727-584-9500",
            "fax_number": "727-584-9502"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TRACY S FANSLER MD LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-09-14",
        "last_updated": "2019-01-14",
        "status": "A",
        "authorized_official_last_name": "FANSLER",
        "authorized_official_first_name": "TRACY",
        "authorized_official_middle_name": "S",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "727-584-9500",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Obstetrics & Gynecology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "261667000",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Largo, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 14, 2019; 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.