Individual provider Active NPI

Tracey L Sarris, M.S.CCC-SLP

  • Speech-Language Pathologist
  • Terre Haute, IN
National Provider Identifier
1942361795
Registry record updated May 9, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
22002247A Issued in IN
Practice address
7227 S Kingswood St
Terre Haute, IN 47802-7857
Phone
(812) 299-4959
Fax
(812) 298-9691
NPI assigned
Dec 13, 2006
Last updated
May 9, 2008By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 9, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Speech-Language Pathologist 235Z00000X 22002247A IN Primary

Addresses

Primary practice location

7227 S Kingswood St
Terre Haute, IN 47802-7857

Mailing address

7227 S Kingswood St
Terre Haute, IN 47802-7857
Phone (812) 299-4959

Other identifiers 1

IdentifierTypeStateIssuer
200612420MedicaidIN

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

LicenseStateTypeSpecialty
22002247AINMDSpeech-Language Pathologist

NPI Registry JSON

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

{
    "created_epoch": "1165968000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1210291200000",
    "number": "1942361795",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7227 S KINGSWOOD ST",
            "city": "TERRE HAUTE",
            "state": "IN",
            "postal_code": "478027857",
            "telephone_number": "812-299-4959",
            "fax_number": "812-298-9691"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7227 S KINGSWOOD ST",
            "city": "TERRE HAUTE",
            "state": "IN",
            "postal_code": "478027857",
            "telephone_number": "812-299-4959",
            "fax_number": "812-298-9691"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SARRIS",
        "first_name": "TRACEY",
        "middle_name": "L",
        "name_prefix": "Mrs.",
        "credential": "M.S.CCC-SLP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-12-13",
        "last_updated": "2008-05-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "IN",
            "license": "22002247A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200612420",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Terre Haute, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 9, 2008; 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.