Tracey Renee Ticcony, N.P.C.

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

4704269996 Issued in MI

Practice address

455 Barclay Cir
Suite D
Rochester Hills, MI 48307-4774

Phone

(248) 852-9596

Fax

(248) 852-9453

NPI assigned

Aug 13, 2013

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in MI

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

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: traceyticcony@kmgpc.allscriptsdirect.net

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.

• Karle Medical Group, P.C.

  • Family Medicine Physician
  • Rochester Hills, MI
  • NPI 1932298379

  MI

  Medicare reassignment NPD

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

{
    "created_epoch": "1376352000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1720656000000",
    "number": "1013340108",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "455 BARCLAY CIR",
            "address_2": "SUITE D",
            "city": "ROCHESTER HILLS",
            "state": "MI",
            "postal_code": "483074774",
            "telephone_number": "248-852-9596",
            "fax_number": "248-852-9453"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "455 BARCLAY CIR",
            "address_2": "SUITE D",
            "city": "ROCHESTER HILLS",
            "state": "MI",
            "postal_code": "483074774",
            "telephone_number": "248-852-9596",
            "fax_number": "248-852-9453"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TICCONY",
        "first_name": "TRACEY",
        "middle_name": "RENEE",
        "name_prefix": "Ms.",
        "credential": "N.P.C.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-08-13",
        "last_updated": "2024-07-11",
        "certification_date": "2024-07-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "MI",
            "license": "4704269996",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MI",
            "license": "4704269996",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jason Rance Thompson, LPC
• Maryss Ashleigh Thompson
• Michelle Thompson
• Tiffany Raye Thompson, MA, LLP
• Christine Tibaldi-Rice
• Tienken Dental Inc.
• Timothy a Hramits MD PC
• Timothy McAleer
• Tina Abraham DO PLLC
• Tisa K Testai DO.,PC

• Family Nurse Practitioner in Rochester Hills, MI
• Providers in Rochester Hills, MI by specialty
• Family Nurse Practitioner in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 11, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.