DR. TRACEY HITCHEN MYATT (NPI# 1225078744) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1225078744 |
| Entity Type | Individual |
| Full Name | DR. TRACEY HITCHEN MYATT |
| Credential | M.D. |
| Practice Address |
154 Waterman St Providence RI 02906-3116 |
| Mailing Address |
36 Methyl St Providence RI 02906-4902 |
| Practice Telephone | 4013834411 |
| Practice Fax Number | 4013836010 |
| Mailing Telephone | 4012732468 |
| Enumeration Date | 2006-06-07 |
| Last Update Date | 2008-01-24 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2080A0000X |
Pediatrics Specialization: Adolescent Medicine |
M.D.11993 | RI | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| RI | DEA | BM9590351 | 01 |
| Street Address |
154 WATERMAN ST |
| City | PROVIDENCE |
| State | RI |
| Zip Code | 02906-3116 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1548266323 | Leonard W. Labush | Podiatrist | 154 Waterman St, Providence, RI 02906-3116 | 2005-06-25 |
| 1588229132 | James Brennan | Physical Therapy Assistant | 154 Waterman St, Providence, RI 02906-3116 | 2019-05-08 |
| 1851832638 | Mark Clayton De Binder Sr. | Reflexologist | 154 Waterman St, Providence, RI 02906-3116 | 2017-03-14 |
| 1285189423 | Jeffrey Drury | Clinical Nurse Specialist | 154 Waterman St, Providence, RI 02906-3116 | 2016-08-17 |
| 1235517913 | Brian Ackerman | Psychiatry & Neurology | 154 Waterman St, Suite 16, Providence, RI 02906-3116 | 2015-05-13 |
| 1104261460 | Paul J Letendre | Counselor | 154 Waterman St, Suite 8, Providence, RI 02906-3116 | 2013-04-30 |
| 1841582376 | Laura M Giusti | Psychologist | 154 Waterman St, 3 West, Providence, RI 02906-3116 | 2011-05-02 |
| 1447554696 | Ciara Byrne | Counselor | 154 Waterman St, Providence, RI 02906-3116 | 2011-01-03 |
| 1003119793 | Royal Health & Wellness | Chiropractor | 154 Waterman St, Suite 1b, Providence, RI 02906-3116 | 2010-12-17 |
| 1003049883 | Kapedjanie Bois | Chiropractor | 154 Waterman St, Ste 1b, Providence, RI 02906-3116 | 2009-08-27 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1285245175 | Birdsong Traditional Medicine, LLC | Acupuncturist | 148 Waterman St. Ground Level, Providence, RI 02906 | 2020-08-13 |
| 1881218071 | Madison Pomerantz | Psychiatry & Neurology | 345 Blackstone Boulevard, Box G-bh, Providence, RI 02906 | 2020-06-03 |
| 1316453855 | Ellen Van Ingen Darling | Psychologist | 285 Governor St Ste 250, Providence, RI 02906 | 2017-12-20 |
| 1275063919 | Marissa Martz | Psychiatry & Neurology | 345 Blackstone Blvd., Providence, RI 02906 | 2017-06-15 |
| 1235663220 | Alena Haltzman | Counselor | 223 Summit Ave, Providence, RI 02906 | 2017-04-17 |
| 1669823399 | Kathryn Fleming-ives LLC | Psychiatry & Neurology | 355 Hope St Unit 1, Providence, RI 02906 | 2016-06-23 |
| 1134573389 | Sarah E. Kramer | Psychiatry & Neurology | Butler Hospital, Adult Psychiatry Residency, 345 Blackstone Blvd, Providence, RI 02906 | 2016-04-13 |
| 1538534201 | Laura Anne Buss | Social Worker | 55 Hope St., Providence, RI 02906 | 2015-12-07 |
| 1700289360 | Tinatin Surguladze | Counselor | 205 Waterman St Suite 106, Providence, RI 02906 | 2014-09-26 |
| 1467851519 | Jamila Allouane | Social Worker | 120 Wayland Avenue Suite 2, Providence, RI 02906 | 2014-08-14 |
| Find all providers in zip 02906 | ||||
| Taxonomy Code | 2080A0000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Pediatrics |
| Specialization | Adolescent Medicine |
| A pediatrician who specializes in adolescent medicine is a multi-disciplinary healthcare specialist trained in the unique physical, psychological and social characteristics of adolescents, their healthcare problems and needs. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Pediatrics, 2007. http://www.abp.org/. American Osteopathic Board of Pediatrics, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Pediatrics. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Pediatrics. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1639499395 | Jack Rusley | Pediatrics | 1 Hoppin St Ste 305, Providence, RI 02903-4141 | 2010-06-04 |
| 1427296300 | Abigail Alcock Donaldson | Pediatrics | 1 Hoppin Street, Suite 3055, Providence, RI 02903 | 2009-01-30 |
| 1588607519 | William Joseph Morocco | Pediatrics | 154 Waterman St, Suite 3, Providence, RI 02906-3116 | 2006-06-14 |
| 1699720961 | Rosalind Vaz | Pediatrics | 1 Hoppin St, Coro West, Providence, RI 02903-4141 | 2006-05-24 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1285857219 | E.p. Mennillo, M.d., Inc | Pediatrics | 994 Reservoir Ave, Cranston, RI 02910-5122 | 2007-04-10 |
| 1790830339 | Santiago Medical Group, Inc. | Pediatrics | 967 Mineral Spring Avenue, North Providence, RI 02904-4934 | 2007-01-24 |
| 1780737296 | We Luv Kids Inc | Pediatrics | 85 Beach St # B, Westerly, RI 02891-2717 | 2007-01-19 |
| 1215015136 | Northern Rhode Island Pediatrics | Pediatrics | 2140 Mendon Rd Ste 201, Cumberland, RI 02864-3833 | 2006-11-01 |
| 1912098336 | Miguel A Fuentes | Pediatrics | 967 Mineral Spring Ave, North Providence, RI 02904-4934 | 2006-09-28 |
| 1639260656 | Robert Arthur Brogan | Pediatrics | 27 Division St, East Greenwich, RI 02818-3872 | 2006-09-27 |
| 1700841616 | Lauren C Noel | Pediatrics | 46 Holley St, Wakefield, RI 02879-3325 | 2006-04-20 |
| 1093776296 | Russell Drew Stokes | Pediatrics | 85 Beach St, Suite B, Westerly, RI 02891-2717 | 2006-03-29 |
| 1497752265 | Alan Robin G. Wallace | Pediatrics | 372 Purgatory Rd, Middletown, RI 02842-5963 | 2005-07-07 |
| 1891792065 | Dante A. Ramos | Pediatrics | 126 Prospect St, Pawtucket, RI 02860-4429 | 2005-07-03 |
| Find all providers with the same taxonomy | ||||
| City | PROVIDENCE |
| Zip Code | 02906 |
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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.