Active NPI
Tracy A. Lacina
- Specialist
- Coralville, IA
National Provider Identifier
1952609034
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Specialist
- License
- 0067686
- Practice address
- 2771 Oakdale Blvd Ste 8
Coralville, IA 52241-9747 - Phone
- (319) 936-1319
- Fax
- (319) 665-3781
- NPI assigned
- Mar 14, 2011
- 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 |
|---|---|---|---|---|
| Specialist | 174400000X | 0067686 | IA | Primary |
Addresses
Primary practice location
2771 Oakdale Blvd Ste 8
Coralville, IA 52241-9747
Mailing address
2771 Oakdale Blvd. Ste. 8
Coralville, IA 52241
Phone (319) 936-1319
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 |
|---|---|---|---|
| 0067686 | IA | MD | Specialist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1300060800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1300060800000",
"number": "1952609034",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2771 OAKDALE BLVD. STE. 8",
"city": "CORALVILLE",
"state": "IA",
"postal_code": "52241",
"telephone_number": "319-936-1319",
"fax_number": "319-665-3781"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2771 OAKDALE BLVD STE 8",
"city": "CORALVILLE",
"state": "IA",
"postal_code": "522419747",
"telephone_number": "319-936-1319",
"fax_number": "319-665-3781"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LACINA",
"first_name": "TRACY",
"middle_name": "A.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2011-03-14",
"last_updated": "2011-03-14",
"status": "A"
},
"taxonomies": [
{
"code": "174400000X",
"taxonomy_group": "",
"desc": "Specialist",
"state": "IA",
"license": "0067686",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Coralville, IA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 14, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.