TRACY BLYETH (NPI# 1215537139) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1215537139 |
| Entity Type | Individual |
| Full Name | TRACY BLYETH |
| Practice Address |
3200 John Williams Blvd Bedford IN 47421-9153 |
| Practice Telephone | 8122750415 |
| Practice Fax Number | 8122750375 |
| Mailing Telephone | 8122750415 |
| Mailing Fax Number | 8122750375 |
| Enumeration Date | 2020-10-29 |
| Last Update Date | 2020-10-29 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1835P0018X |
Pharmacist Specialization: Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist |
26015475A | IN | Pharmacy Service Providers |
| Street Address |
3200 JOHN WILLIAMS BLVD |
| City | BEDFORD |
| State | IN |
| Zip Code | 47421-9153 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1346268760 | Wal-mart Stores East Lp | Durable Medical Equipment & Medical Supplies | 3200 John Williams Blvd, Bedford, IN 47421-9153 | 2006-07-17 |
| 1093315988 | Brian Scott Darnell | Pharmacist | 3200 John Williams Blvd, Bedford, IN 47421-9153 | 2020-10-29 |
| 1255931432 | Michelle Lynn Goldsberry | Pharmacist | 3200 John Williams Blvd, Bedford, IN 47421-9153 | 2020-10-28 |
| 1174123152 | Rebecca L Jones | Pharmacist | 3200 John Williams Blvd, Bedford, IN 47421-6085 | 2020-10-28 |
| 1689203044 | Cathy Frances Deringer | Pharmacist | 3200 John Williams Blvd, Bedford, IN 47421-6085 | 2020-04-07 |
| 1881932309 | John Walton Od PC | Optometrist | 3200 John Williams Blvd, Bedford, IN 47421-9153 | 2013-01-17 |
| 1902938145 | Wal-mart Stores, Inc. | Technician/Technologist | 3200 John Williams Blvd, Bedford, IN 47421 | 2007-03-12 |
| 1700984697 | Melinda Jo Trager | Optometrist | 3200 John Williams Blvd, Bedford, IN 47421 | 2006-09-21 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1114406303 | Leana Michelle Massimini | Speech-Language Pathologist | 3710 Kenneth Simpson Ln, Bedford, IN 47421 | 2018-08-09 |
| 1497246888 | Sara Lehr Corry | Counselor | 2325 Q St., Bedford, IN 47421 | 2018-05-22 |
| 1760737274 | Lisa Lynne Autry | Social Worker | 2125 16th Street, Bedford, IN 47421 | 2012-07-20 |
| 1285998153 | Reid Clipp Crosby | Obstetrics & Gynecology | 118woodhill Dr, Bedford, IN 47421 | 2012-06-26 |
| 1730453184 | Fields Chiropractic Inc | Chiropractor | 2418 W 16th St, Bedford, IN 47421 | 2012-03-02 |
| 1639461783 | Lori Wininger | Physical Therapy Assistant | 2137 16th Street, Bedford, IN 47421 | 2011-05-09 |
| 1871743716 | Union Optical and Eyecare Center, Inc. | Optometrist | 3343 Michael Ave, Bedford, IN 47421 | 2008-09-29 |
| 1326207176 | Ross Wright | Surgery | 179 Shawswick Road, Bedford, IN 47421 | 2008-06-06 |
| 1336320563 | The Health and Hospital Corporation of Marion County | Skilled Nursing Facility | 1510 Clinic Dr, Bedford, IN 47421 | 2007-11-15 |
| 1306031992 | Assisted Living Concepts Inc | Assisted Living Facility | 3008 Shawnee Drive, South Bedford, IN 47421 | 2007-09-07 |
| Find all providers in zip 47421 | ||||
| Taxonomy Code | 1835P0018X |
| Grouping | Pharmacy Service Providers |
| Classification | Pharmacist |
| Specialization | Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist |
| Pharmacist Clinician/Clinical Pharmacy Specialist is a pharmacist with additional training and an expanded scope of practice that may include prescriptive authority, therapeutic management, and disease management. |
| Notes: Source: National Uniform Claim Committee, 2007 [1/1/2008: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1275151946 | Sima Sheth Patel | Pharmacist | 112 Pine Hill Rd, Bedford, MA 01730-1658 | 2020-07-09 |
| 1093315988 | Brian Scott Darnell | Pharmacist | 3200 John Williams Blvd, Bedford, IN 47421-9153 | 2020-10-29 |
| 1255931432 | Michelle Lynn Goldsberry | Pharmacist | 3200 John Williams Blvd, Bedford, IN 47421-9153 | 2020-10-28 |
| 1265032262 | Bhavinkumar Patel | Pharmacist | 1126 E Lynchburg Salem Tpke, Bedford, VA 24523-3446 | 2020-10-28 |
| 1174123152 | Rebecca L Jones | Pharmacist | 3200 John Williams Blvd, Bedford, IN 47421-6085 | 2020-10-28 |
| 1942808365 | Rex Gueffroy | Pharmacist | 2109 Harwood Rd, Bedford, TX 76021-4705 | 2020-10-16 |
| 1194351486 | Joanne Meyer | Pharmacist | 21 Ferris Ln, Bedford, NY 10506-1715 | 2020-03-18 |
| 1831723279 | Corinne Renee Pruett | Pharmacist | 1206 16th St, Bedford, IN 47421-3707 | 2020-02-25 |
| 1366073025 | David D Saunders | Pharmacist | 2109 Harwood Rd, Bedford, TX 76021-4705 | 2020-01-31 |
| 1427688738 | Laura Cummings | Pharmacist | 2631 16th St, Bedford, IN 47421-3581 | 2020-01-26 |
| Find all providers in BEDFORD | ||||
Please comment or provide details below to improve the information on TRACY BLYETH.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.