TRACY JO ELLIS (NPI# 1649664442) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1649664442 |
| Entity Type | Individual |
| Full Name | TRACY JO ELLIS |
| Credential | LMT |
| Practice Address |
157 W Hayden Ave Hayden Lake ID 83835-9650 |
| Mailing Address |
1628 W Judy K Dr Rathdrum ID 83858-7502 |
| Practice Telephone | 5092163663 |
| Mailing Telephone | 5092163663 |
| Enumeration Date | 2015-03-19 |
| Last Update Date | 2015-03-19 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 171W00000X | Contractor | MAS-1492 | ID | Other Service Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1992273734 | Tracy Ellis | Psychologist | 70 N Main St Ste 104, Bountiful, UT 84010-6115 | 2018-11-09 |
| 1669080180 | Tracy Ellis | Behavior Technician | 8805 W 14th Ave, Suite 100, Lakewood, CO 80215-4848 | 2020-07-21 |
| 1962890426 | Tracy Ellis | Specialist/Technologist, Other | 9499 W Charleston Blvd, Ste 200, Las Vegas, NV 89117-7150 | 2015-01-06 |
| 1982974622 | Tracy Kent Ellis | Behavioral Analyst | 900 N Broadway St, Poteau, OK 74953-2617 | 2012-01-11 |
| 1679895700 | Tracy Ellis | Chiropractor | 10317 Greenbriar Pkwy, Oklahoma City, OK 73159-7648 | 2010-02-16 |
| 1326292707 | Tracy Ellis | Rehabilitation Practitioner | 9808 Venice Blvd Ste 700, Culver City, CA 90232-6824 | 2008-11-11 |
| Street Address |
157 W HAYDEN AVE |
| City | HAYDEN LAKE |
| State | ID |
| Zip Code | 83835-9650 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1881212371 | Ngan T Nguyen | Pharmacist | 161 E. Prairie Shopping Center, Hayden, ID 83835 | 2020-07-10 |
| 1689158461 | Rskiom, Pllc | Electrodiagnostic Medicine | 9323 N Government Way #6, Hayden, ID 83835 | 2018-09-18 |
| 1235616913 | Kimberly Jill Young | Dietitian, Registered | 8500 N. Atlas Rd., Hayden, ID 83835 | 2018-07-25 |
| 1851894380 | Medicine Man North Pharmacy Inc | Pharmacy | 30585 N Roberts Rd, Hayden, ID 83835 | 2018-03-11 |
| 1366997322 | Jennifer Amber Belmont | Social Worker | 8680 N Wayne Dr, Suite A, Hayden, ID 83835 | 2016-08-19 |
| 1548637994 | Dance Dentistry Pllc | Clinic/Center | 1027 W Prairie Ave, Hayden, ID 83835 | 2015-09-01 |
| 1982012498 | Dallin J. Dance | Dentist | 1027 W. Prairie Ave., Hayden, ID 83835 | 2014-07-28 |
| 1669808614 | Integrated Interventions LLC | Clinic/Center | 2482 E. Glacier Rd., Hayden Lake, ID 83835 | 2013-09-23 |
| 1669812301 | Caleb Jerome Foss | Physical Therapist | 8382 N Wayne Dr Ste 100, Hayden, ID 83835 | 2013-06-26 |
| 1437493798 | Joseph Neal Tessendorf | Chiropractor | 1401 Biztown Loop, Hayden, ID 83835 | 2012-11-26 |
| Find all providers in zip 83835 | ||||
| Taxonomy Code | 171W00000X |
| Grouping | Other Service Providers |
| Classification | Contractor |
| A person who contracts to supply certain materials or do certain work for a stipulated sum; esp., one whose business is contracting work in any of the building trades. For purposes of the taxonomy, a person who contracts to complete home repairs or modifications to accommodate a health condition (e.g. wheelchair ramp, kitchen counter lowering). |
| Notes: Source: Websters New World Dictionary of the American Language, Second College Edition, William Collins + World Publishing Co., Inc., New York: 1974, p. 308 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1881235893 | Juli Stratton | Contractor | 2598 N Abigail St, Post Falls, ID 83854-6201 | 2019-10-01 |
| 1114585163 | Cory Bruce Langberg | Contractor | 5362 W Prairie Ave, Post Falls, ID 83854-5912 | 2019-06-04 |
| 1093237935 | Jason Earl Bailey | Contractor | 3100 S Woodruff Ave., Idaho Falls, ID 83404 | 2017-07-12 |
| 1750815510 | Ideal Solutions, Inc. | Contractor | 1317 E 65th N, Idaho Falls, ID 83401-5653 | 2017-04-18 |
| 1003208638 | Vickey Schmadeka | Contractor | 8565 W Stonehaven St, Boise, ID 83704-7079 | 2015-02-18 |
| 1346643095 | Brandy Burch | Contractor | 1417 N Hartman St, Boise, ID 83704-8849 | 2014-10-08 |
| 1215270053 | Crista Ann Jardine | Contractor | 2499 Fieldstone Dr, Ammon, ID 83401-5854 | 2013-03-29 |
| 1346515889 | Doris Faye Thornock | Contractor | 444 N 10th St, Montpelier, ID 83254-1115 | 2012-03-16 |
| 1245532381 | Cesar Ledezma | Contractor | 3265 Canyon Pl, Twin Falls, ID 83301-8180 | 2010-11-22 |
| 1851558126 | Desiree F Welty | Contractor | 1059 Pinewood Cir, Twin Falls, ID 83301-3338 | 2008-05-22 |
| Find all providers with the same taxonomy | ||||
| City | HAYDEN LAKE |
| Zip Code | 83835 |
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| 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.