MRS. TRACY HART (NPI# 1659985158) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1659985158 |
| Entity Type | Individual |
| Full Name | MRS. TRACY HART |
| Credential | CRPA-P |
| Practice Address |
80 State Highway 310 Ste 1 Canton NY 13617-1493 |
| Practice Telephone | 3153862189 |
| Practice Fax Number | 3153862435 |
| Mailing Telephone | 3153862189 |
| Mailing Fax Number | 3153862435 |
| Enumeration Date | 2020-09-02 |
| Last Update Date | 2020-09-02 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 175T00000X | Peer Specialist | Other Service Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1396220216 | Tracy Rae Hart | Social Worker | 24 Salt Pond Road, Suite H1, Wakefield, RI 02879 | 2018-09-26 |
| 1124272414 | Tracy L. Hart | Social Worker | 7 Old Sherman Tpke, Suite 205, Danbury, CT 06810-4174 | 2008-11-12 |
| 1851471130 | Tracy Tucker Hart | Pharmacist | 1101 Veterans Dr, Lexington, KY 40502-2235 | 2006-10-17 |
| Street Address |
80 STATE HIGHWAY 310 STE 1 |
| City | CANTON |
| State | NY |
| Zip Code | 13617-1493 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1043304645 | Patricia Pielnik | Psychiatry & Neurology | 80 State Highway 310 Ste 1, Canton, NY 13617-1436 | 2006-10-03 |
| 1689232860 | Randyl Shane Chase | Counselor | 80 State Highway 310 Ste 1, Canton, NY 13617-1493 | 2019-06-03 |
| 1891285631 | Brianna Kessler | Student in an Organized Health Care Education/Training Program | 80 State Highway 310 Ste 1, Canton, NY 13617-1493 | 2018-05-17 |
| 1720588742 | Lakshmi Nair | Registered Nurse | 80 State Highway 310 Ste 1, Canton, NY 13617-1436 | 2018-02-16 |
| 1669879060 | Kaylie E. Deshane | Counselor | 80 State Highway 310 Ste 1, Canton, NY 13617-1436 | 2014-12-01 |
| 1447667878 | Kristina Beth Kelly-snow | Counselor | 80 State Highway 310 Ste 1, Canton, NY 13617-1436 | 2014-07-17 |
| 1376827196 | Gidget Q.v. Rafus-rousell | Counselor | 80 State Highway 310 Ste 1, St. Lawrence County Community, Canton, NY 13617-1436 | 2011-09-29 |
| 1922288844 | Cynthia J Provow | Obstetrics & Gynecology | 80 State Highway 310 Ste 1, Canton, NY 13617-1436 | 2007-11-08 |
| 1376664425 | Sheri L Page | Registered Nurse | 80 State Highway 310 Ste 1, Canton, NY 13617-1436 | 2007-04-03 |
| 1346371705 | Antoine Gabriel | Psychiatry & Neurology | 80 State Highway 310 Ste 1, Canton, NY 13617-1436 | 2007-03-08 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1700428802 | Meagan Elizabeth Hogan | Physician Assistant | 6119 Us Highway Route 11, Canton, NY 13617 | 2019-10-10 |
| 1982251740 | Wilma J. Blackmer | Technician | 1756 Cr 14, Canton, NY 13617 | 2019-08-26 |
| 1326525270 | Kylie Broughal | Physician Assistant | 6119 St Hwy Rt 11, St Lawrence Medical Office Complex, Canton, NY 13617 | 2018-07-24 |
| 1891299608 | Sheena Teresa Smith | Counselor | 310 State Highway 310, Suite 1, Canton, NY 13617 | 2018-03-19 |
| 1972024594 | Patrick James Sullivan | Physician Assistant | 6619 State Highway Route 11, Canton, NY 13617 | 2017-07-05 |
| 1225482763 | Howard Orthotics and Prosthetics, LLC | Prosthetic/Orthotic Supplier | 6128 Us Highway11, Canton, NY 13617 | 2016-04-21 |
| 1831534452 | Chin Hung Ho | Dermatology | 6119 State Highway Rt 11, Cph Dermotology, Canton, NY 13617 | 2013-05-09 |
| 1194061663 | Sarah Prairie | Counselor | 80 State Hwy 310, Suite 1, Canton, NY 13617 | 2013-01-02 |
| 1679859094 | Nathan Ellis | Occupational Therapist | 139 Outer State St. Rd, Canton, NY 13617 | 2011-10-31 |
| 1407139017 | Julianne Rutley | Occupational Therapist | 139 Outer State Street Rd, Canton, NY 13617 | 2011-09-21 |
| Find all providers in zip 13617 | ||||
| Taxonomy Code | 175T00000X |
| Grouping | Other Service Providers |
| Classification | Peer Specialist |
| Individuals certified to perform peer support services through a training process defined by a government agency, such as the Department of Veterans Affairs or a state mental health department/certification/licensing authority. |
| Notes: Source: National Uniform Claim Committee [7/1/2014: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1093350068 | Marc A Walker | Peer Specialist | 3311 12th St Nw, Canton, OH 44708-3909 | 2019-11-13 |
| 1114569506 | Nicole Herndon | Peer Specialist | 1114 Gonder Ave Se, Canton, OH 44707-3300 | 2019-10-17 |
| 1588138390 | Angela Rhoad | Peer Specialist | Coleman Professional Services 400 Tuscarawas St W., Canton, OH 44702 | 2019-01-15 |
| 1851864144 | Jennifer Kathleen Shannon | Peer Specialist | 2945 Willowrow Ave Ne, Canton, OH 44705-3612 | 2019-01-09 |
| 1861962599 | Darnella L Jenkins | Peer Specialist | 2306 Crown Pl Nw, Canton, OH 44708-4420 | 2018-11-26 |
| 1396229027 | Michelle Lois Stackhouse | Peer Specialist | 5736 East Blvd Nw, Canton, OH 44718-1655 | 2018-09-19 |
| 1922520865 | Marc Slotnick | Peer Specialist | 43825 Michigan Ave., Canton, MI 48188 | 2017-07-12 |
| 1427656354 | Aaron Schreffler | Peer Specialist | 401 Tuscarawas St W Ste 501, Canton, OH 44702-2045 | 2020-10-13 |
| 1790309581 | Jamaine Thomas Atkins Sr. | Peer Specialist | 50430 School House Rd, Canton, MI 48187-5910 | 2020-06-08 |
| 1093338154 | Elvis Mcgrath | Peer Specialist | 1920 Schneider St Ne, Canton, OH 44721-3352 | 2020-05-24 |
| Find all providers in CANTON | ||||
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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.