Individual provider Active NPI

Stephanie Sue Tracey, APRN

  • Advanced Practice Midwife
  • Lutz, FL
National Provider Identifier
1043844087
Registry record updated Feb 21, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Advanced Practice MidwifeTaxonomy code 367A00000X
License
APRN11006336 Issued in FL
Practice address
106 Myrtle Ridge Rd
Lutz, FL 33549-5632
Phone
(813) 949-1185
NPI assigned
Feb 28, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 21, 2024

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Midwife 176B00000X
Obstetrics & Gynecology Nurse Practitioner 363LX0001X APRN1106336 FL
Advanced Practice Midwife 367A00000X APRN11006336 FL Primary

Addresses

Primary practice location

106 Myrtle Ridge Rd
Lutz, FL 33549-5632

Mailing address

PO Box 25317
Tampa, FL 33622-5317
Phone (813) 286-0033

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20200803002926 FL Practitioner - Certified Nurse Midwife (CNM) 3678998937 Reassigns benefits to 3 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Certified Nurse Midwife

State licenses

LicenseStateTypeSpecialty
APRN1106336FLMDObstetrics & Gynecology Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Women'S Care Florida LLC Advanced Practice Midwife CurrentSince Jul 30, 2020 Accepting new patients
Womens' Health Hospitalists, LLC CurrentSince Jul 30, 2020 Accepting new patients
Vitalmd Group Holding LLC CurrentSince Jan 3, 2022 Accepting new patients

Locations

8340 Lakewood Ranch Blvd
Ste 140
Lakewood Ranch, FL 34202
Phone (941) 782-2800

3225 Aviation Ave
Ste 700
Miami, FL 33133
Phone (305) 273-4641

625 6th Ave S
Ste 350
St Petersburg, FL 33701
Phone (727) 456-0080

2818 W Virginia Ave
Tampa, FL 33607
Phone (813) 872-8551

4030 W Boy Scout Blvd
Ste 800
Tampa, FL 33607
Phone (813) 286-0333

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1582848000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1708473600000",
    "number": "1043844087",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 25317",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336225317",
            "telephone_number": "813-286-0033",
            "fax_number": "813-282-1806"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "106 MYRTLE RIDGE RD",
            "city": "LUTZ",
            "state": "FL",
            "postal_code": "335495632",
            "telephone_number": "813-949-1185"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TRACEY",
        "first_name": "STEPHANIE",
        "middle_name": "SUE",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-02-28",
        "last_updated": "2024-02-21",
        "certification_date": "2024-02-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "176B00000X",
            "taxonomy_group": "",
            "desc": "Midwife",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363LX0001X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Obstetrics & Gynecology",
            "state": "FL",
            "license": "APRN1106336",
            "primary": false
        },
        {
            "code": "367A00000X",
            "taxonomy_group": "",
            "desc": "Advanced Practice Midwife",
            "state": "FL",
            "license": "APRN11006336",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lutz, FL

Sources for this page

Verify at the official NPI Registry.