Individual provider Active NPI

Tracy Ann Schirm, RN

  • Addiction (Substance Use Disorder) Registered Nurse
  • South Amboy, NJ
National Provider Identifier
1902508294
Registry record updated Mar 20, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Addiction (Substance Use Disorder) Registered NurseTaxonomy code 163WA0400X
License
26NO09568500 Issued in NJ
Practice address
901 Ernston Rd
South Amboy, NJ 08879-2000
Phone
(732) 654-3165
Fax
(732) 838-3433
NPI assigned
Mar 20, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 20, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Psychiatric/Mental Health Registered Nurse 163WP0809X 26NO09568500 NJ
Addiction (Substance Use Disorder) Registered Nurse 163WA0400X 26NO09568500 NJ Primary

Addresses

Primary practice location

901 Ernston Rd
South Amboy, NJ 08879-2000

Mailing address

35 Wedgewood Cir
Eatontown, NJ 07724-1212
Phone (732) 796-2294

Other names 1

  • Ms. Tracy Ann Gomez Professional name

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
Registered Nurse

State licenses

LicenseStateTypeSpecialty
26NO09568500NJMDAdult Psychiatric/Mental Health Registered Nurse

NPI Registry JSON

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

{
    "created_epoch": "1679270400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1679270400000",
    "number": "1902508294",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "35 WEDGEWOOD CIR",
            "city": "EATONTOWN",
            "state": "NJ",
            "postal_code": "077241212",
            "telephone_number": "732-796-2294"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "901 ERNSTON RD",
            "city": "SOUTH AMBOY",
            "state": "NJ",
            "postal_code": "088792000",
            "telephone_number": "732-654-3165",
            "fax_number": "732-838-3433"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SCHIRM",
        "first_name": "TRACY",
        "middle_name": "ANN",
        "name_prefix": "Ms.",
        "credential": "RN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-03-20",
        "last_updated": "2023-03-20",
        "certification_date": "2023-03-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WP0809X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Psychiatric/Mental Health, Adult",
            "state": "NJ",
            "license": "26NO09568500",
            "primary": false
        },
        {
            "code": "163WA0400X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Addiction (Substance Use Disorder)",
            "state": "NJ",
            "license": "26NO09568500",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "TRACY",
            "last_name": "GOMEZ",
            "middle_name": "ANN",
            "prefix": "MS.",
            "credential": "RN",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

Other providers in South Amboy, NJ

Sources for this page

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