Individual provider Active NPI

Tracy Leigh Ladner, C.F.N.P

  • Family Nurse Practitioner
  • Gulfport, MS
National Provider Identifier
1003239294
Registry record updated Sep 23, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
R850568 Issued in MS
Practice address
15200 Community Rd
Gulfport, MS 39503-3085
Phone
(228) 575-7000
NPI assigned
Jan 24, 2014
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 23, 2016

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X R850568 MS Primary

Addresses

Primary practice location

15200 Community Rd
Gulfport, MS 39503-3085

Mailing address

PO Box 1729
Hattiesburg, MS 39403-1729
Phone (601) 545-8700

Other identifiers 1

IdentifierTypeStateIssuer
09330877MedicaidMS

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MS
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20140331000478 MS Practitioner - Nurse Practitioner 1951532225 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
R850568MSMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Hattiesburg Community Dental Center CurrentSince Oct 10, 2016 Accepting new patients
Keystone Medical Services of Ms, Inc CurrentSince Jul 2, 2014 Accepting new patients
Sumrall Family Health Center CurrentSince Oct 10, 2016 Accepting new patients
New Augusta Family Health Center Past Accepting new patients
Petal School Clinic Past Accepting new patients
Brooklyn Family Health Center Past Accepting new patients
Lamar County School Clinic Past Accepting new patients
N R Burger School and Community Clinic Past Accepting new patients
Lumberton Family Health Center Past Accepting new patients
Seminary Family Health Center Past Accepting new patients
Minor Care Clinic Past Accepting new patients
Southeast Mississippi Rural Health Initiative, Inc. Past Accepting new patients
Picayune Family Health Center Past Accepting new patients
Hattiesburg Public School and Community Clinic Past Accepting new patients
Beaumont Family Health Center Past Accepting new patients
Women'S Health Center Past Accepting new patients
Hattiesburg High School and Community Clinic Past Accepting new patients
Semrhi Mobile Healthcare Unit Past Accepting new patients

Locations (25 of 46)

215 Old Highway 49 E
Brooklyn, MS 39425
Phone 60154587002217

8 Burborne St
Brooklyn, MS 39425
Phone (601) 545-7714

44 Brooklyn Janice Rd
Brooklyn, MS 39425
Phone (601) 582-1188

1560 Sumrall Rd
Columbia, MS 39429
Phone (601) 736-6303

2207 W 7th St
Hattiesburg, MS 39401
Phone (601) 450-6500

1760 Old Highway 24
Hattiesburg, MS 39402
Phone (601) 264-6724

70 Leaf Ln
Hattiesburg, MS 39402
Phone (601) 264-9764

316 Travillion Rd
Hattiesburg, MS 39401
Phone (601) 584-9303

605 Stadium Dr
Hattiesburg, MS 39401
Phone (601) 450-0310

301 Hutchinson Ave
Hattiesburg, MS 39401
Phone (601) 450-6101

62 Old Airport Rd
Hattiesburg, MS 39401
Phone (601) 544-4550

66 Old Airport Rd
Hattiesburg, MS 39401
Phone (601) 544-7500

693 Eatonville Rd
Hattiesburg, MS 39401
Phone 60125526602217

404 Lillie Burney St
Hattiesburg, MS 39401
Phone (601) 450-6500

500 Martin Luther King Ave
Hattiesburg, MS 39401
Phone (601) 583-0960

10 Archie Smith Rd
Hattiesburg, MS 39402
Phone (601) 268-2217

5198 Old Highway 11
Hattiesburg, MS 39402
Phone (601) 264-7232

5279 W 4th St
Hattiesburg, MS 39402
Phone (601) 264-3858

901 Ida Ave
Hattiesburg, MS 39401
Phone (601) 582-5291

702 Eatonville Rd
Hattiesburg, MS 39401

2900 Jamestown Rd
Hattiesburg, MS 39402
Phone (601) 255-2660

526 Forrest St
Hattiesburg, MS 39401
Phone (601) 583-4311

790 Elks Lake Rd
Hattiesburg, MS 39401
Phone (601) 582-4890

2006 Oferral St
Hattiesburg, MS 39401
Phone (601) 583-8112

123 S 27th Ave
Hattiesburg, MS 39401
Phone (601) 450-3030

Interoperability endpoints

  • Direct secure messaging: tladner101548@directpatientrecord.com

Organizations & group practices 18

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

View all 18

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Southeast Mississippi Rural Health Initiative, Inc. 38 clinicians

Practice addresses (Care Compare)

1911 Read Rd
Picayune, MS 39466-2730
Phone (601) 251-3500

Hospital & facility affiliations

  • Highland Community Hospital Hospital, Picayune, MS, CCN 250117

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1390521600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1474588800000",
    "number": "1003239294",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1729",
            "city": "HATTIESBURG",
            "state": "MS",
            "postal_code": "394031729",
            "telephone_number": "601-545-8700",
            "fax_number": "601-450-2493"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15200 COMMUNITY RD",
            "city": "GULFPORT",
            "state": "MS",
            "postal_code": "395033085",
            "telephone_number": "228-575-7000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LADNER",
        "first_name": "TRACY",
        "middle_name": "LEIGH",
        "credential": "C.F.N.P",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-01-24",
        "last_updated": "2016-09-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MS",
            "license": "R850568",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "09330877",
            "state": "MS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Gulfport, MS

Sources for this page

Verify at the official NPI Registry.