Active NPI
Tracey Dickey, STNA
- Nurse's Aide
- Canton, OH
National Provider Identifier
1922435619
On this page
OIG exclusion record
The HHS Office of Inspector General’s List of Excluded Individuals/Entities (LEIE) contains a record with this NPI:
- Section 1128a(1) exclusion effective Oct 20, 2020.
Key facts
NPPES NPI Registry- Primary specialty
- Nurse's Aide
- License
- 401401230612
- Practice address
- 413 Gibbs Ave NE
Canton, OH 44704-1531 - Phone
- (330) 546-4231
- NPI assigned
- Sep 26, 2013
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Nurse's Aide | 376K00000X | 401401230612 | OH | Primary |
Addresses
Primary practice location
413 Gibbs Ave NE
Canton, OH 44704-1531
Mailing address
413 Gibbs Ave NE
Canton, OH 44704
Phone (330) 546-4231
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
- HHS exclusion list flag
- Flagged The directory lists this NPI on an HHS exclusion list.
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 401401230612 | OH | MD | Nurse's Aide |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1380153600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1380153600000",
"number": "1922435619",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "413 GIBBS AVE NE",
"city": "CANTON",
"state": "OH",
"postal_code": "44704",
"telephone_number": "330-546-4231"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "413 GIBBS AVE NE",
"city": "CANTON",
"state": "OH",
"postal_code": "447041531",
"telephone_number": "330-546-4231"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DICKEY",
"first_name": "TRACEY",
"name_prefix": "Miss",
"credential": "STNA",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2013-09-26",
"last_updated": "2013-09-26",
"status": "A"
},
"taxonomies": [
{
"code": "376K00000X",
"taxonomy_group": "",
"desc": "Nurse's Aide",
"state": "OH",
"license": "401401230612",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Canton, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 26, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; OIG LEIE.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.