Active NPI
Tracy Lynn Bicknell
- Registered Nurse
- Callaway, MD
National Provider Identifier
1922779909
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Nurse
- License
- 0001216990
- Practice address
- 20907 Jo Marie Way
Callaway, MD 20620-2322 - Phone
- (301) 437-6588
- NPI assigned
- Sep 21, 2021
- Last updated
- Sep 21, 2021
- Sex
- Female
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Registered Nurse | 163W00000X | 0001216990 | VA | Primary |
Addresses
Primary practice location
20907 Jo Marie Way
Callaway, MD 20620-2322
Mailing address
20907 Jo Marie Way
Callaway, MD 20620-2322
Phone (301) 437-6588
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
| License | State | Type | Specialty |
|---|---|---|---|
| 0001216990 | VA | MD | Registered Nurse |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1632182400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1632182400000",
"number": "1922779909",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "20907 JO MARIE WAY",
"city": "CALLAWAY",
"state": "MD",
"postal_code": "206202322",
"telephone_number": "301-437-6588"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "20907 JO MARIE WAY",
"city": "CALLAWAY",
"state": "MD",
"postal_code": "206202322",
"telephone_number": "301-437-6588"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BICKNELL",
"first_name": "TRACY",
"middle_name": "LYNN",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2021-09-21",
"last_updated": "2021-09-21",
"certification_date": "2021-09-21",
"status": "A"
},
"taxonomies": [
{
"code": "163W00000X",
"taxonomy_group": "",
"desc": "Registered Nurse",
"state": "VA",
"license": "0001216990",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Callaway, MD
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 21, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.