Active NPI
Tracey Clark
- Personal Care Attendant
- Washington, DC
National Provider Identifier
1942830047
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Personal Care Attendant
- Practice address
- 930 Farragut St NW
Washington, DC 20011-3944 - Phone
- (202) 892-8120
- NPI assigned
- Jan 17, 2020
- 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 |
|---|---|---|---|---|
| Personal Care Attendant | 3747P1801X | Primary |
Addresses
Primary practice location
930 Farragut St NW
Washington, DC 20011-3944
Mailing address
5758 Central Ave SE
Washington, DC 20019-6549
Phone (202) 760-7531
Other practice location 1
1118 46th St NE Apt 1B
Washington, DC 20019-3844
Phone (202) 766-9633
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
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1579219200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1729123200000",
"number": "1942830047",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5758 CENTRAL AVE SE",
"city": "WASHINGTON",
"state": "DC",
"postal_code": "200196549",
"telephone_number": "202-760-7531"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "930 FARRAGUT ST NW",
"city": "WASHINGTON",
"state": "DC",
"postal_code": "200113944",
"telephone_number": "202-892-8120"
}
],
"practiceLocations": [
{
"address_1": "1118 46th St NE Apt 1B",
"address_purpose": "LOCATION",
"city": "Washington",
"state": "DC",
"postal_code": "200193844",
"country_code": "US",
"telephone_number": "202-766-9633",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "CLARK",
"first_name": "TRACEY",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2020-01-17",
"last_updated": "2024-10-17",
"certification_date": "2024-10-17",
"status": "A"
},
"taxonomies": [
{
"code": "3747P1801X",
"taxonomy_group": "",
"desc": "Technician, Personal Care Attendant",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Washington, DC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 17, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.