TRACY LEE NEILY (NPI# 1811505068) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1811505068 |
| Entity Type | Individual |
| Full Name | TRACY LEE NEILY |
| Practice Address |
3400 Executive Dr Raleigh NC 27609-7476 |
| Practice Telephone | 9198215221 |
| Mailing Telephone | 9198215221 |
| Enumeration Date | 2020-07-14 |
| Last Update Date | 2020-07-14 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 224900000X | Mastectomy Fitter | NC | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| Street Address |
3400 EXECUTIVE DR |
| City | RALEIGH |
| State | NC |
| Zip Code | 27609-7476 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1821068313 | Lorraine Faith Birmingham | Family Medicine | 3400 Executive Dr, Suite 201, Raleigh, NC 27609-7476 | 2006-01-25 |
| 1417234238 | Angelia M Flanagan Md Pa | Family Medicine | 3400 Executive Dr, Suite 101, Raleigh, NC 27609-7476 | 2011-11-08 |
| 1427350438 | Michelle Futrell | Dietitian, Registered | 3400 Executive Dr, Raleigh, NC 27609-7476 | 2010-11-23 |
| 1932371879 | Center for Orthotic and Prosthetic Care of North Carolina, Inc | Prosthetic/Orthotic Supplier | 3400 Executive Dr, Ste 102, Raleigh, NC 27609-7476 | 2008-04-01 |
| 1760607907 | Christopher James Messina Sr. | Psychologist | 3400 Executive Dr, Suite 205, Raleigh, NC 27609-7476 | 2007-04-14 |
| 1992821482 | Sandy J. Kimmel, D.o., P.a. | Specialist | 3400 Executive Dr, Suite 203, Raleigh, NC 27609-7476 | 2007-03-22 |
| 1689790081 | Raleigh Family Health Care | Family Medicine | 3400 Executive Dr, Suite 201, Raleigh, NC 27609-7476 | 2007-03-21 |
| 1942256326 | Angelia M Flanagan | Family Medicine | 3400 Executive Dr, Suite 101, Raleigh, NC 27609-7476 | 2006-05-26 |
| 1598714313 | Sandy Jean Kimmel | Psychiatry & Neurology | 3400 Executive Dr, Suite 203, Raleigh, NC 27609-7476 | 2006-05-09 |
| 1790756971 | Alger Vason Hamrick IIi | Family Medicine | 3400 Executive Dr, Suite 102, Raleigh, NC 27609-7476 | 2006-01-27 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1184235582 | Choice Service Solutions LLC | In Home Supportive Care | 5300 Six Fox Rd Siite205, Raleigh, NC 27609 | 2020-08-11 |
| 1003426073 | Rosana Oba -rovira | Registered Nurse | 5300 Six Fox Road, Suite 205, Raleigh, NC 27609 | 2020-08-05 |
| 1821612706 | Helen Alexandra Bonner | Physical Medicine & Rehabilitation | Hey Clinic Pa, 3320 Wake Forest Road Ste 450, Raleigh, NC 27609 | 2020-06-05 |
| 1215423579 | Appiah Nana Larbi | Social Worker | Easter Seals Ucp 4000 Wake Forest Rd Ste 200, Raleigh, NC 27609 | 2018-07-10 |
| 1215423777 | Broadway Home Care LLC | In Home Supportive Care | 107 Windel Dr Ste 105, Raleigh, NC 27609 | 2018-07-09 |
| 1275027948 | Lacey Allene Cottingham | Social Worker | 312 W Millbrook Rd Ste 129, Raleigh, NC 27609 | 2018-06-18 |
| 1447748819 | Integrated Dermatology of North Raleigh, Pllc | Dermatology | 3809 Computer Dr Ste 200, Raleigh, NC 27609 | 2018-05-01 |
| 1902325418 | Naomi Christine Askew | Nurse Practitioner | 3400 Wake Forest Drive, Bldg 9, Bldg #9, 4th Floor, Raleigh, NC 27609 | 2017-09-15 |
| 1962929679 | Alexia Montague | Social Worker | 1306 Paddock Drive Suite E-100, Raleigh, NC 27609 | 2017-08-23 |
| 1730602236 | Chantel Washington-mbuthia | Counselor | 1100 Logger Ct. Ste C100, Heartfelt Alternative Inc, Raleigh, NC 27609 | 2017-07-18 |
| Find all providers in zip 27609 | ||||
| Taxonomy Code | 224900000X |
| Grouping | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| Classification | Mastectomy Fitter |
| An individual trained in the fitting and adjusting of breast prostheses and management of post-mastectomy prostheses services. |
| Notes: Source: National Uniform Claim Committee [7/1/2010: new] Additional Resources: American Board for Certification in Orthotics, Prosthetics and Pedorthics, Inc., www.abcop.org and Board of Certification/Accreditation, International, www.bocusa.org. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1689917874 | Christina P May | Mastectomy Fitter | 3224 Lake Woodard Dr, Raleigh, NC 27604-3659 | 2013-04-05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1497355036 | Tonyan Wilson Hunter | Mastectomy Fitter | 125 E Council St, Salisbury, NC 28144-5019 | 2020-10-30 |
| 1043784762 | Kathleen Wylie | Mastectomy Fitter | 4252 Arendell St Ste C, Morehead City, NC 28557-0015 | 2019-01-15 |
| 1609375310 | Teresa Medford | Mastectomy Fitter | 583 Asheville Hwy Ste 3, Sylva, NC 28779-5114 | 2018-02-08 |
| 1659801488 | Superior Home Medical, Inc | Mastectomy Fitter | 201 N Main St Ste 110, Monroe, NC 28112-4753 | 2017-06-14 |
| 1245615160 | Tiffani Ross | Mastectomy Fitter | 17436 Midnight Express Way, Cornelius, NC 28031-8180 | 2015-07-21 |
| 1558707661 | Kimberly Anne Twine | Mastectomy Fitter | 113 Baxter Ln Ste 8, Moyock, NC 27958-8792 | 2013-05-15 |
| 1841827995 | Brittany Taylor White | Mastectomy Fitter | 106 Medical Dr, Elizabeth City, NC 27909-3361 | 2020-03-26 |
| 1518514041 | Cathy M Cliff | Mastectomy Fitter | 702 Jefferson St, Whiteville, NC 28472-3706 | 2019-08-20 |
| 1134689326 | Destiny S Davis | Mastectomy Fitter | 405 W 15th St, Washington, NC 27889-3524 | 2019-03-22 |
| 1104383751 | Hope Taylor-miller | Mastectomy Fitter | 1636 Tate Blvd Se, Hickory, NC 28602-4244 | 2019-03-01 |
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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.