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Champion Community Partners, LLC

Psychiatric/Mental Health Nurse Practitioner in Massapequa Park, NY · enumerated 2025 · authorized official Tracey Wallace, Vp Ops.

Data current as of Jul 13, 2026 · sourced from CMS NPPES

National Provider Identifier

1922989144

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Registry record

Entity type Organization (Type 2)
Legal business name Champion Community Partners, LLC
Practice address 5100 Sunrise Hwy, Massapequa Park, NY, 11762
Phone (631) 696-4357
Enumeration date Sep 12, 2025
Last updated in NPPES Sep 12, 2025

Taxonomy & classification

363LP0808X Psychiatric/Mental Health Nurse Practitioner Physician Assistants & Advanced Practice Nursing Providers Primary

Authorized official

Name Tracey Wallace
Title Vp Ops
Phone (631) 696-4357

What is an NPI number?

A National Provider Identifier (NPI) is a unique 10-digit number that CMS assigns to every U.S. healthcare provider and organization under HIPAA. Type 1 NPIs identify individual providers; Type 2 NPIs identify organizations. The NPI appears on insurance claims, prescriptions, and credentialing paperwork, and never changes, even if the provider moves or changes specialty.

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Frequently asked questions

What is the NPI number for Champion Community Partners, LLC?
The NPI for Champion Community Partners, LLC is 1922989144, a Type 2 (organization) record in the CMS NPPES registry.
Who is the authorized official for Champion Community Partners, LLC?
NPPES lists Tracey Wallace (Vp Ops) as the authorized official for this organization.

Providers at this address

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Source: CMS NPPES (public data). Snapshot 2026-07-13. Provider record last updated 2025-09-12.