ELIZABETH TRACY (NPI# 1699757591) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1699757591 |
| Entity Type | Individual |
| Full Name | ELIZABETH TRACY |
| Credential | M.D. |
| Practice Address |
1027 Bellevue Ave Suite 107 Saint Louis MO 63117-1851 |
| Mailing Address |
Po Box 23340 Saint Louis MO 63156-3340 |
| Practice Telephone | 3146453743 |
| Practice Fax Number | 3146477967 |
| Mailing Telephone | 3146453743 |
| Mailing Fax Number | 3146477967 |
| Enumeration Date | 2005-11-16 |
| Last Update Date | 2012-10-01 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207R00000X | Internal Medicine | R6J71 | MO | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MO | MERCY | E62302 | 01 |
| MO | ESSENCE | 000000010039 | 01 |
| MO | HEALTHLINK | 101209 | 01 |
| MO | GHP | 127483 | 01 |
| MO | UHC | 0400404 | 01 |
| MO | BCBS | 16533 | 01 |
| MO | AETNA | 4090137 | 01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1528039427 | Elizabeth Catherine Tracy | Nurse Practitioner | 2130 E Main St, Montrose, CO 81401-3834 | 2006-01-30 |
| 1528610920 | Elizabeth Tracy | Technician | 1005 Terminal Way Ste 125, Reno, NV 89502-2198 | 2019-07-15 |
| 1275064313 | Elizabeth Tracy | Behavior Technician | 2909 Oregon Ct, A1, Torrance, CA 90503-2645 | 2017-03-21 |
| 1578918363 | Elizabeth Ann Tracy | Physician Assistant | 1500 N 28th St, Richmond, VA 23223-5332 | 2016-04-28 |
| 1336464452 | Elizabeth L. Tracy | Counselor | 153 Center Rd, Venice, FL 34285-5572 | 2010-03-31 |
| 1659426476 | Elizabeth A Tracy | Social Worker | 380 Lafayette Rd, #11-312, Seabrook, NH 03874-4551 | 2007-01-24 |
| 1174588529 | Elizabeth Tracy | Specialist | 9940 Talbert Ave, Suite 303, Fountain Valley, CA 92708-5153 | 2006-04-19 |
| Street Address |
1027 BELLEVUE AVE SUITE 107 |
| City | SAINT LOUIS |
| State | MO |
| Zip Code | 63117-1851 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1477558070 | Heather Wuebker | Obstetrics & Gynecology | 1027 Bellevue Ave, Ste 200, Saint Louis, MO 63117-1851 | 2005-06-20 |
| 1467088948 | Kelsey Galicia | Occupational Therapist | 1027 Bellevue Ave, Saint Louis, MO 63117-1996 | 2020-03-17 |
| 1457815854 | Katie Vandegriffe | Social Worker | 1027 Bellevue Ave, Saint Louis, MO 63117-1851 | 2019-01-30 |
| 1588128276 | Jessica Everage | Social Worker | 1027 Bellevue Ave, Saint Louis, MO 63117-1851 | 2019-01-26 |
| 1326512690 | Jessica Lynn Gangwes | Social Worker | 1027 Bellevue Ave, Saint Louis, MO 63117-1851 | 2019-01-19 |
| 1750870440 | Bailey Christian Kohrs | Occupational Therapist | 1027 Bellevue Ave, Saint Louis, MO 63117-1851 | 2018-05-08 |
| 1609308584 | Katie Palubiak | Nurse Practitioner | 1027 Bellevue Ave, Suite 200, Saint Louis, MO 63117-1851 | 2017-03-30 |
| 1083153787 | Alante Q Ghannam | Nurse Practitioner | 1027 Bellevue Ave, Ste 107, Saint Louis, MO 63117-1851 | 2017-02-15 |
| 1730639493 | Amy Mosier | Speech-Language Pathologist | 1027 Bellevue Ave, Attn: Amy K Mosier, Saint Louis, MO 63117-1851 | 2016-10-06 |
| 1104215631 | Mabel Anti | Nurse Practitioner | 1027 Bellevue Ave, 3rd Floor, Saint Louis, MO 63117-1851 | 2015-01-21 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1255956611 | Efehi Kelly Ogbomo | Student in an Organized Health Care Education/Training Program | 6420 Clayton Rd, Suite 2218, St. Louis, MO 63117 | 2020-06-11 |
| 1619533890 | Abdul Rauf | Student in an Organized Health Care Education/Training Program | 6420 Clayton Road. Ssm Health St. Mary's Hospital, St. Louis, MO 63117 | 2019-05-14 |
| 1083278477 | Mohamed Maali Gumaa Mohamed | Student in an Organized Health Care Education/Training Program | 6420 Clayton Road Ssm St. Mary's Hospital, Department of Internal Medicine, St. Louis, MO 63117 | 2019-05-01 |
| 1750945556 | Samrat Jun Jayanth | Student in an Organized Health Care Education/Training Program | 6420 Clayton Road, Ssm Health St Mary's Hospital, St. Louis, MO 63117 | 2019-04-26 |
| 1215491329 | Latonya Allen | Counselor | 1612 S. Big Bend Blvd, St. Louis, MO 63117 | 2019-01-23 |
| 1265917025 | Blue Stars Therapy, LLC | Occupational Therapist | 1101 Edward Terrace, Apt A, St. Louis, MO 63117 | 2018-09-27 |
| 1770060014 | Ultra Care Home Services LLC | Home Health | 7353 Dale Ave, Saint Louis, MO 63117 | 2018-07-19 |
| 1235623562 | Melissa Valerie Taylor | Counselor | Psychological Services of St Louis, LLC, 7110 Oakland Ave, St Louis, MO 63117 | 2018-06-20 |
| 1124517289 | Jideofor Ebony Obodozie | Student in an Organized Health Care Education/Training Program | 6420 Clayton Road, Ssm St. Mary's Hospital, St. Louis, MO 63117 | 2018-05-04 |
| 1770071706 | Sivaram Prabhuji Muppaneni | Student in an Organized Health Care Education/Training Program | Ssm St Mary's Hospital, 6420 Clayton Road, St. Louis, MO 63117 | 2018-04-25 |
| Find all providers in zip 63117 | ||||
| Taxonomy Code | 207R00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Internal Medicine |
| A physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer, infections and diseases affecting the heart, blood, kidneys, joints and digestive, respiratory and vascular systems. They are also trained in the essentials of primary care internal medicine, which incorporates an understanding of disease prevention, wellness, substance abuse, mental health and effective treatment of common problems of the eyes, ears, skin, nervous system and reproductive organs. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source; 7/1/2011: modified source] - Additional Resources: American Board of Internal Medicine, 2007. http://www.abim.org/. American Osteopathic Board of Internal Medicine, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Internal Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Internal Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1780223933 | Glenn C. Jacobsen | Internal Medicine | 7 Carrswold Dr, Saint Louis, MO 63105-2914 | 2020-01-04 |
| 1396305868 | Kevin Colin O'fee | Internal Medicine | 1 Barnes Jewish Hospital Plz # 90-29928, Saint Louis, MO 63110-1003 | 2019-06-17 |
| 1144740200 | Michael Slade | Internal Medicine | 660 S Euclid Ave # 8056-29, Saint Louis, MO 63110-1010 | 2017-06-20 |
| 1386171312 | Niaz Memon | Internal Medicine | 625 S New Ballas Rd Ste 7020, Saint Louis, MO 63141-8218 | 2017-05-22 |
| 1043746027 | Paul David Olivo | Internal Medicine | 639 W Polo Dr, Saint Louis, MO 63105-2635 | 2017-05-11 |
| 1649706243 | Jared Frisby | Internal Medicine | 1100 S Grand Blvd Fl 8, Saint Louis, MO 63104-1015 | 2017-05-03 |
| 1518417708 | Md At Home LLC | Internal Medicine | 6 Portland Pl, Saint Louis, MO 63108-1204 | 2016-10-11 |
| 1285087429 | Kathryn Parker | Internal Medicine | 1000 Des Peres Rd Ste 300, Saint Louis, MO 63131 | 2016-07-22 |
| 1831540863 | John Kirby Krause Jr. | Internal Medicine | 1031 Highlands Plaza Dr W, Apt 510, Saint Louis, MO 63110-1303 | 2016-06-30 |
| 1104277458 | Vedica Sharma | Internal Medicine | 10010 Kennerly Rd Ste 140, Saint Louis, MO 63128-2106 | 2016-06-28 |
| Find all providers in SAINT LOUIS | ||||
| City | SAINT LOUIS |
| Zip Code | 63117 |
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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.