Individual provider Active NPI

Traci Hurley, MD

  • Pediatrics Physician
  • Scottsdale, AZ
National Provider Identifier
1922057090
Registry record updated Nov 4, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
29547 Issued in AZ
Practice address
10752 N 89TH PL
Suite 126
Scottsdale, AZ 85260-6730
Phone
(480) 860-2754
Fax
(480) 860-6561
NPI assigned
May 8, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 4, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 29547 AZ Primary

Addresses

Primary practice location

10752 N 89TH PL
Suite 126
Scottsdale, AZ 85260-6730

Mailing address

10752 N 89TH PL
Suite 126
Scottsdale, AZ 85260-6730
Phone (480) 860-2754

Other identifiers 1

IdentifierTypeStateIssuer
634114-001MedicaidAZ

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
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
29547AZMDPediatrics Physician

NPI Registry JSON

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

{
    "created_epoch": "1147046400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1383523200000",
    "number": "1922057090",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10752 N 89TH PL",
            "address_2": "SUITE 126",
            "city": "SCOTTSDALE",
            "state": "AZ",
            "postal_code": "852606730",
            "telephone_number": "480-860-2754",
            "fax_number": "480-860-6561"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10752 N 89TH PL",
            "address_2": "SUITE 126",
            "city": "SCOTTSDALE",
            "state": "AZ",
            "postal_code": "852606730",
            "telephone_number": "480-860-2754",
            "fax_number": "480-860-6561"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HURLEY",
        "first_name": "TRACI",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-05-08",
        "last_updated": "2013-11-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "AZ",
            "license": "29547",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "634114-001",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Scottsdale, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 4, 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.