TRACY KELLAM
NPI 1104498344
Contractor in Youngstown, OH

Active since July 16, 2021
4120 EUCLID BLVD, YOUNGSTOWN, OH 44512(330) 984-1505 Get Directions Write a Review

NPPES record last updated: July 16, 2021. Verified against the NPPES registry weekly; last sync: August 16, 2026.

About Tracy Kellam NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

TRACY KELLAM (NPI 1104498344) is an individual contractor provider in Youngstown, Ohio, licensed in Ohio (0325993) and active in the NPI registry since July 2021.

NPPES Registry Identity

NPI1104498344
Entity TypeIndividualFemale
Primary Taxonomy171W00000X
Provider Legal NameTRACY KELLAM
Location Address4120 EUCLID BLVDYoungstown, OH 44512-1305
Mailing Address4120 Euclid BlvdYoungstown, OH 44512-1305 · (330) 984-1505
Sole ProprietorYes
Enumeration DateJuly 16, 2021
NPPES CertifiedJuly 16, 2021
NPI 1104498344 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Primary SpecialtyContractorOther Service Providers
Taxonomy Code171W00000X
License Licensed in OH · 0325993
Definition
For the purposes of the Health Care Provider Taxonomy, a contractor is limited to individuals who do construction or mechanical work to modify a patient's environment to accommodate a health condition. Contractors perform projects including, but not limited to, building wheelchair ramps, widening doorways, modifying personal vehicles, and making other improvements for patient access and movement. This code has no relation to a provider's employment status.
4120 EUCLID BLVD, Youngstown, OH 44512

Other Identifiers 1

Medicaid0325993OH

Other Providers at the Same Location NPPES

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

Home Health Aide
4120 EUCLID BLVD
YOUNGSTOWN, OH 44512

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Tracy Kellam's NPI number?

The NPI number for Tracy Kellam is 1104498344. It was assigned to this individual provider in the NPPES registry on July 16, 2021.

Where is Tracy Kellam located?

Tracy Kellam practices at 4120 Euclid Blvd, Youngstown, OH 44512. The listed phone number is (330) 984-1505.

What is Tracy Kellam's specialty?

The primary specialty registered for this NPI is Contractor with taxonomy code 171W00000X.

When was this NPI record last updated?

The NPPES record for Tracy Kellam was last updated on July 16, 2021. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.