TRACY ELLIS (NPI# 1992273734) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1992273734 |
| Entity Type | Individual |
| Full Name | TRACY ELLIS |
| Credential | PSYD |
| Practice Address |
70 N Main St Ste 104 Bountiful UT 84010-6115 |
| Practice Telephone | 8012985222 |
| Practice Fax Number | 8012940295 |
| Mailing Telephone | 8012985222 |
| Mailing Fax Number | 8012940295 |
| Enumeration Date | 2018-11-09 |
| Last Update Date | 2018-11-09 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 103TC0700X |
Psychologist Specialization: Clinical |
10949998-2501 | UT | Behavioral Health & Social Service Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1669080180 | Tracy Ellis | Behavior Technician | 8805 W 14th Ave, Suite 100, Lakewood, CO 80215-4848 | 2020-07-21 |
| 1649664442 | Tracy Jo Ellis | Contractor | 157 W Hayden Ave, Hayden Lake, ID 83835-9650 | 2015-03-19 |
| 1962890426 | Tracy Ellis | Specialist/Technologist, Other | 9499 W Charleston Blvd, Ste 200, Las Vegas, NV 89117-7150 | 2015-01-06 |
| 1982974622 | Tracy Kent Ellis | Behavioral Analyst | 900 N Broadway St, Poteau, OK 74953-2617 | 2012-01-11 |
| 1679895700 | Tracy Ellis | Chiropractor | 10317 Greenbriar Pkwy, Oklahoma City, OK 73159-7648 | 2010-02-16 |
| 1326292707 | Tracy Ellis | Rehabilitation Practitioner | 9808 Venice Blvd Ste 700, Culver City, CA 90232-6824 | 2008-11-11 |
| Street Address |
70 N MAIN ST STE 104 |
| City | BOUNTIFUL |
| State | UT |
| Zip Code | 84010-6115 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1063070605 | Brooke Kumar | Social Worker | 70 N Main St Ste 104, Bountiful, UT 84010-6115 | 2019-05-30 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1225699192 | Jessyca K Willie | Behavior Technician | 415 S. Medical Drive Suite D101, Bountiful, UT 84010 | 2019-06-21 |
| 1336634344 | Shanna Joy Jaggers | Social Worker | 2333 S 200 E, Bountiful, UT 84010 | 2018-06-22 |
| 1447773171 | Live Life Alarms | Emergency Response System Companies | 640 South 500 West, Bountiful, UT 84010 | 2017-07-25 |
| 1902328842 | Hailey Embley | Behavior Technician | 415 Medical Drive D 101, Bountiful, UT 84010 | 2017-07-12 |
| 1508318031 | Beverly Nielsen | Psychologist | 1001 Lakeview Drive, Bountiful, UT 84010 | 2016-11-01 |
| 1295287720 | Samantha Oslund | Speech-Language Pathologist | 415 Medical Dr Ste B102, Bountiful, UT 84010 | 2016-11-01 |
| 1750748273 | Jeremy Clark Morris | Dentist | 59 W 1600 N, Suite 110, Bountiful, UT 84010 | 2016-01-28 |
| 1629464706 | Shane James | Speech-Language Pathologist | 425 Medical Dr Ste 122, Bountiful, UT 84010 | 2015-04-15 |
| 1891186102 | Kenton Francis | Social Worker | 1355 North Main Street #1, Bountiful, UT 84010 | 2015-02-09 |
| 1205233855 | Modern Dental Professionals - Utah, PC | Dentist | 24 S. 500 West, #a, Bountiful, UT 84010 | 2014-11-25 |
| Find all providers in zip 84010 | ||||
| Taxonomy Code | 103TC0700X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Psychologist |
| Specialization | Clinical |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1588935134 | Richard King Mower, Ph.d.,p.c. | Psychologist | 505 S Main St, Bountiful, UT 84010-6398 | 2012-01-13 |
| 1053346494 | Donald Randall | Psychologist | 630 Medical Dr, Bountiful, UT 84010-4908 | 2006-07-12 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1205433059 | Steven Lucero | Psychologist | 93 S 1250 E, Logan, UT 84321-6770 | 2020-10-05 |
| 1023627759 | Wasatch Front Wellness, Pllc | Psychologist | 940 N 400 E Ste 3, North Salt Lake, UT 84054-1945 | 2020-07-29 |
| 1376165530 | Kirsten Leigh Graham | Psychologist | 351 W University Blvdgeneral Classrooms 308-o, General Classrooms 308-o, Cedar City, UT 84720 | 2020-05-11 |
| 1467073833 | Realign Psychology LLC | Psychologist | 1042 E Fort Union Blvd, #1085, Midvale, UT 84047-1800 | 2020-04-27 |
| 1508404344 | Rith Counseling and Assessment Pllc | Psychologist | 10432 S 4000 W, South Jordan, UT 84009-5729 | 2019-12-11 |
| 1780230433 | Carolynne Elizabeth Baron | Psychologist | Va Salt Lake City Healthcare System 500 Foothill Drive, Salt Lake City, UT 84148-0001 | 2019-08-16 |
| 1255999637 | Thomas Golightly | Psychologist | 1500 Wsc Byu, Provo, UT 84602 | 2019-05-31 |
| 1639732571 | Scott A Baldwin | Psychologist | 1190 N 900 E Ofc 285, Provo, UT 84604-3536 | 2019-04-16 |
| 1407311087 | Hiu Wai Caldwell | Psychologist | 796 E. Pacific Drive Suite B, American Fork, UT 84003-8400 | 2019-02-07 |
| 1770069981 | Vanessa Blair Watts | Psychologist | 1740 Combe Rd Ste 5, Ogden, UT 84403-5094 | 2018-07-11 |
| Find all providers with the same taxonomy | ||||
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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.