Active NPI
Fern Tracey, RPH
- Pharmacist
- Las Vegas, NV
National Provider Identifier
1932790540
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 09913
- Practice address
- 4800 W Charleston Blvd
Las Vegas, NV 89146-1400 - Phone
- (702) 877-9026
- NPI assigned
- Jan 27, 2021
- Last updated
- Jan 27, 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 |
|---|---|---|---|---|
| Pharmacist | 183500000X | 09913 | NV | Primary |
Addresses
Primary practice location
4800 W Charleston Blvd
Las Vegas, NV 89146-1400
Mailing address
PO Box 95784
Las Vegas, NV 89193-5784
Phone (702) 510-3608
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 Pharmacist
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 09913 | NV | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Nevada CVS Pharmacy LLC | Past | Accepting new patients |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1611705600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1611705600000",
"number": "1932790540",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 95784",
"city": "LAS VEGAS",
"state": "NV",
"postal_code": "891935784",
"telephone_number": "702-510-3608"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4800 W CHARLESTON BLVD",
"city": "LAS VEGAS",
"state": "NV",
"postal_code": "891461400",
"telephone_number": "702-877-9026"
}
],
"practiceLocations": [],
"basic": {
"last_name": "TRACEY",
"first_name": "FERN",
"name_prefix": "Ms.",
"credential": "RPH",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2021-01-27",
"last_updated": "2021-01-27",
"certification_date": "2021-01-27",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "NV",
"license": "09913",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Las Vegas, NV
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 27, 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.