Tracy Black, S.L.P.

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

2202003640 Issued in VA

Practice address

7864 US Hwy 117 S
Rocky Point, NC 28457-9458

Phone

(259) 122-4910

NPI assigned

Jun 16, 2010

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Legacy Healthcare Services Inc

  • Physical Therapist
  • Cary, NC
  • NPI 1225879489

  Speech-Language Pathologist

  NPD
• Legacy Healthcare Services, Inc.

  • Physical Therapist
  • Durham, NC
  • NPI 1104823400

  Speech-Language Pathologist

  NPD

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

{
    "created_epoch": "1276646400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1707091200000",
    "number": "1982925731",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4168 BREEZEWOOD DR APT 201",
            "city": "WILMINGTON",
            "state": "NC",
            "postal_code": "284122468",
            "telephone_number": "540-616-4525"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7864 US HWY 117 S",
            "city": "ROCKY POINT",
            "state": "NC",
            "postal_code": "284579458",
            "telephone_number": "259-122-4910"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BLACK",
        "first_name": "TRACY",
        "credential": "S.L.P.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-06-16",
        "last_updated": "2024-02-05",
        "certification_date": "2024-02-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "VA",
            "license": "2202003640",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Mariela Avila, LCSWA, LCASA
• Talisa Bannerman-Lee, P.T., DPT
• Kevin D Baskin
• Catharine Batson
• Black River Health Services, Inc. (Black River Family Practice at Rocky Point)
• Shanna Pollock Bradshaw, PA
• Carol Burkie
• Michael B Bush, DDS
• Sarah Abbitt Bush, MS, RD
• Carolina Healthcare Associates Inc (Pender Primary Care - Rocky Point)

• Speech-Language Pathologist in Rocky Point, NC
• Providers in Rocky Point, NC by specialty
• Speech-Language Pathologist in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 5, 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.

Verify at the official NPI Registry.