TRACIE LYN HANSEN B.S.
NPI 1639779523
Peer Specialist in Pocatello, ID
NPI Status: Active since October 29, 2020
Contact Information
560 FAIRWAY DR
POCATELLO, ID
ZIP 83201
Phone: (208) 242-6669
- Individual
- Female
- Peer Specialist
About TRACIE HANSEN
This page provides the complete NPI Profile along with additional information for Tracie Hansen, a provider established in Pocatello, Idaho with a medical specialization in Peer Specialist. The healthcare provider is registered in the NPI registry with number 1639779523 assigned on October 2020. The practitioner's primary taxonomy code is 175T00000X with license number CPSS055 (ID). The provider is registered as an individual and her NPI record was last updated 2 years ago. Tracie Hansen operates as a multi-specialty business group with one or more individual providers who practice different areas of specialization.
- NPI
- 1639779523
- Provider Name
- TRACIE LYN HANSEN B.S.
- Other Name
- TRACIE LYN BURRUP
- Other Name Type
- Former Name (1)
- Gender
- Female
- Entity Type
- Individual
- Location Address
- 560 FAIRWAY DR POCATELLO, ID 83201
- Location Phone
- (208) 242-6669
- Mailing Address
- 611 WILSON AVE STE 5 POCATELLO, ID 83201
- Mailing Phone
- (208) 915-8448
- Is Sole Proprietor?
- Yes
- Enumeration Date
- 10-29-2020
- Last Update Date
- 04-10-2023
- Code Navigator
Location Map
Specialty - Primary Taxonomy
The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.
- Classification
Peer Specialist
- Taxonomy Code
- 175T00000X
- Type
- Other Service Providers
- License No.
- CPSS055
- License State
- ID
- Taxonomy Description
- Individuals certified to perform peer support services through a training process defined by a government agency, such as the Department of Veterans Affairs or a state mental health department/certification/licensing authority.
Group Taxonomy 193200000X MULTI-SPECIALTY GROUP
This provider is a business group of one or more individual practitioners, who practice with different areas of specialization.
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NPI Validation Check Digit Calculation
The following table explains the step by step NPI number validation process using the ISO standard Luhn algorithm.
| Start with the original NPI number, the last digit is the check digit and is not used in the calculation. | |||||||||
| 1 | 6 | 3 | 9 | 7 | 7 | 9 | 5 | 2 | 3 |
| Step 1: Double the value of the alternate digits, beginning with the rightmost digit. | |||||||||
| 2 | 6 | 6 | 9 | 14 | 7 | 18 | 5 | 4 | |
| Step 2: Add all the doubled and unaffected individual digits from step 1 plus the constant number 24. | |||||||||
| 2 + 6 + 6 + 9 + 1 + 4 + 7 + 1 + 8 + 5 + 4 + 24 = 77 | |||||||||
| Step 3: Subtract the total obtained in step 2 from the next higher number ending in zero, the result is the check digit. | |||||||||
| 80 - 77 = 3 | 3 | ||||||||
The NPI number 1639779523 is valid because the calculated check digit 3 using the Luhn validation algorithm matches the last digit of the original NPI number.
Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1639779523, enumerated as an "individual" on October 29, 2020.
The provider is located at 560 FAIRWAY DR POCATELLO, ID 83201 and the phone number is (208) 242-6669.
Peer Specialist with taxonomy code 175T00000X.
