Tracie Lynn Fitzwater

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

BP00942079 Issued in WV

Practice address

101 S Eisenhower Dr
Beckley, WV 25801-4929

Phone

(204) 256-7100

Fax

(304) 256-7111

NPI assigned

Sep 17, 2019

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1568678400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1568678400000",
    "number": "1972153435",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "101 S EISENHOWER DR",
            "city": "BECKLEY",
            "state": "WV",
            "postal_code": "258014929",
            "telephone_number": "204-256-7100",
            "fax_number": "304-256-7111"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "101 S EISENHOWER DR",
            "city": "BECKLEY",
            "state": "WV",
            "postal_code": "258014929",
            "telephone_number": "204-256-7100",
            "fax_number": "304-256-7111"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FITZWATER",
        "first_name": "TRACIE",
        "middle_name": "LYNN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-09-17",
        "last_updated": "2019-09-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "WV",
            "license": "BP00942079",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "304-256-7100",
            "affiliation": "N",
            "endpointDescription": "FMRS Health Systems",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "101 S Eisenhower Dr",
            "city": "Beckley",
            "state": "WV",
            "country_code": "US",
            "postal_code": "258014929",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• First Settlement Phycial Therapy
• Kristen Grace Fisher, BA
• Tiffany Fisher
• Joanna Fitzpatrick, MS, CCC-SLP
• Carl Fitzwater, PHARMD
• Jane Elinor Flanagan, MSW
• Tiffany Flannery
• Ashley Danielle Fleenor, PA-C
• Brandon Fleenor
• Angelia R. Fleming-Meade, CRT/RN

• Clinical Social Worker in Beckley, WV
• Providers in Beckley, WV by specialty
• Clinical Social Worker in West Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 17, 2019; 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.