TRACEY ANN ECKENROD (NPI# 1679901409) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1679901409 |
| Entity Type | Individual |
| Full Name | TRACEY ANN ECKENROD |
| Credential | MSN CRNP |
| Practice Address |
136 Jaycee Dr Johnstown PA 15904-3650 |
| Mailing Address |
241 Schoolhouse Rd Ste 201 Johnstown PA 15904-3239 |
| Practice Telephone | 8144674055 |
| Practice Fax Number | 8144673783 |
| Mailing Telephone | 8142665650 |
| Mailing Fax Number | 8142665653 |
| Enumeration Date | 2013-10-14 |
| Last Update Date | 2018-09-14 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363LF0000X |
Nurse Practitioner Specialization: Family |
SP013226 | PA | Physician Assistants & Advanced Practice Nursing Providers |
| Street Address |
136 JAYCEE DR |
| City | JOHNSTOWN |
| State | PA |
| Zip Code | 15904-3650 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1316381155 | Beacon Medical, LLC | Anesthesiology | 136 Jaycee Dr, Suite 10, Johnstown, PA 15904-3650 | 2013-04-23 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1407368699 | Shari Mcclaren | Counselor | 1360 Eisenhower Blvd, Ste 404, Johnstown, PA 15904 | 2017-10-29 |
| 1881126928 | Pain Medicine of York, LLC | Anesthesiology | 136 Jaycee Dr Ste 10, Johnstown, PA 15904 | 2017-03-29 |
| 1841660750 | Danielle Nicole Malzi | Occupational Therapist | 222 Luray Avenue, Johnstown, PA 15904 | 2015-10-05 |
| 1710393715 | Dlp Conemaugh Physician Practices LLC | Internal Medicine | 622 Dermuth St., Johnstown, PA 15904 | 2014-07-10 |
| 1043582406 | Bonifacio Tan Aguilera | Family Medicine | 307 Terlyn Drive, Johnstown, PA 15904 | 2012-02-01 |
| 1508159021 | Patricia S Sauka | Social Worker | 865 Eisenhower Boulevard, Johnstown, PA 15904 | 2011-05-17 |
| 1962703520 | Nathaniel Brett Beatty | Audiologist-Hearing Aid Fitter | 141 Town Center Drive, Johnstown, PA 15904 | 2010-11-12 |
| 1831324607 | Medcare Equipment Company, LLC | Durable Medical Equipment & Medical Supplies | 150 Atlantic Street, Johnstown, PA 15904 | 2009-05-22 |
| 1467667766 | Mary Alice K Burtnett | Occupational Therapist | 345 Vo Tech Drive, Johnstown, PA 15904 | 2007-05-11 |
| 1871717280 | Beverly Janik | Counselor | 214 College Park Plaza, Johnstown, PA 15904 | 2007-04-13 |
| Find all providers in zip 15904 | ||||
| Taxonomy Code | 363LF0000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Family |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1053934141 | Oluwakemi Ajiboye | Nurse Practitioner | 2840 Moulard Ct, Johnstown, CO 80534-4660 | 2020-05-22 |
| 1780219980 | Kenneth R Lods | Nurse Practitioner | 411 Tunnel Ave, Johnstown, PA 15905-3726 | 2020-03-08 |
| 1730648221 | Sarah Maria Owens | Nurse Practitioner | 4910 Silverwood Dr, Johnstown, CO 80534-6706 | 2019-03-14 |
| 1649623679 | Michael Joseph Dziagwa I | Nurse Practitioner | 1015 Franklin St Fl D, Johnstown, PA 15905-4155 | 2016-07-14 |
| 1336558733 | Tara L. Peters | Nurse Practitioner | 1322 Eisenhower Blvd., Johnstown, PA 15904-3327 | 2014-08-11 |
| 1578901906 | Laura Ann Caserta | Nurse Practitioner | 434 South Kingsboro Avenue, Johnstown, NY 12095-0010 | 2013-06-07 |
| 1467717934 | Diana Smelter | Nurse Practitioner | 1255 Scalp Ave, Johnstown, PA 15904-3137 | 2012-07-10 |
| 1841356995 | Deborah Lynn Gray | Nurse Practitioner | 308 Patton Ter, Johnstown, PA 15909-1027 | 2006-12-30 |
| 1538175989 | Danita Curtis | Nurse Practitioner | 110 Decker Dr, Suite 100, Johnstown, NY 12095-2157 | 2006-07-31 |
| 1336183151 | A Leslie Bright | Nurse Practitioner | 340 W Coshocton St, Johnstown, OH 43031-1113 | 2006-06-15 |
| Find all providers in JOHNSTOWN | ||||
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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.