Tracey Way Childers, D.O.

Primary specialty

Otolaryngology/Facial Plastic Surgery PhysicianTaxonomy code 207YX0905X

License

3296 Issued in OK

Practice address

1203 E Ross Byp
Suite a
Tahlequah, OK 74464-4188

Phone

(918) 453-1234

Fax

(918) 453-9107

NPI assigned

Mar 24, 2006

Reactivated

May 28, 2024

Last updated

May 28, 2024By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 4

Medicare fee-for-service enrollment

Enrolled in OK, IL2 enrollments

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 2

Specialty

OtolaryngologyAlso: Plastic and Reconstructive Surgery

Education

University of North Texas HSC, College of Osteopathic Med, 1994

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Warren Clinic IncGroup PAC ID 8820900293, 787 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Saint Francis Hospital, Inc Hospital, Tulsa, OK, CCN 370091
• Saint Francis Hospital South, LLC Hospital, Tulsa, OK, CCN 370218
• Saint Francis Hospital Muskogee Hospital, Muskogee, OK, CCN 370025
• Saint Francis Hospital Vinita, Inc Hospital, Vinita, OK, CCN 370237

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: tchilders321080@direct.saintfrancis.com

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

• Warren Clinic Inc

  • General Practice Physician
  • Tulsa, OK
  • NPI 1174582282
  Medicare reassignment Care Compare group NPD
• Tracey W. Childers, D.O. P.C.

  dba Childers Medical Group

  • Otolaryngology Physician
  • Tahlequah, OK
  • NPI 1720274699
  NPD Authorized official
• Osf Multi-Specialty Group

  • Internal Medicine Physician
  • Peoria, IL
  • NPI 1922445527
  Medicare reassignment
• LMC Medical Group LLC

  • Urgent Care Clinic/Center
  • Muskogee, OK
  • NPI 1548697550
  Authorized official Same address or phone
• Central PA Pharmacy LLC.

  dba patton pharmacy and v&s variety

  • Community/Retail Pharmacy
  • Patton, PA
  • NPI 1578541413
  NPD
• Saint Francis Hospital, Inc.

  • General Acute Care Hospital
  • Tulsa, OK
  • NPI 1144228487
  NPD (past)

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

• Saint Francis Hospital Muskogee Inc

  dba Saint Francis Hospital Muskogee

  • General Acute Care Hospital
  • Muskogee, OK
  • NPI 1386188837
  Care Compare affiliation
• Saint Francis Hospital South LLC

  dba Saint Francis Hospital South

  • General Acute Care Hospital
  • Tulsa, OK
  • NPI 1376561944
  Care Compare affiliation
• Saint Francis Hospital Vinita, Inc

  • Medicare Defined Swing Bed Hospital Unit
  • Vinita, OK
  • NPI 1467902460
  Care Compare affiliation
• Saint Francis Hospital Vinita, Inc

  • Psychiatric Hospital Unit
  • Vinita, OK
  • NPI 1578013579
  Care Compare affiliation
• Saint Francis Hospital Vinita, Inc

  • General Acute Care Hospital
  • Vinita, OK
  • NPI 1700334232
  Care Compare affiliation
• Saint Francis Hospital, Inc.

  • Rehabilitation Hospital Unit
  • Tulsa, OK
  • NPI 1003039488
  Care Compare affiliation
• Saint Francis Hospital, Inc.

  • General Acute Care Hospital
  • Tulsa, OK
  • NPI 1144228487
  Care Compare affiliation

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

{
    "created_epoch": "1143158400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1716854400000",
    "number": "1053371021",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1203 E ROSS BYP",
            "address_2": "SUITE A",
            "city": "TAHLEQUAH",
            "state": "OK",
            "postal_code": "744644188",
            "telephone_number": "918-453-1234",
            "fax_number": "918-453-9107"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1203 E ROSS BYP",
            "address_2": "SUITE A",
            "city": "TAHLEQUAH",
            "state": "OK",
            "postal_code": "744644188",
            "telephone_number": "918-453-1234",
            "fax_number": "918-453-9107"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHILDERS",
        "first_name": "TRACEY",
        "middle_name": "WAY",
        "credential": "D.O.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-03-24",
        "last_updated": "2024-05-28",
        "deactivation_date": "2024-05-02",
        "reactivation_date": "2024-05-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207YX0905X",
            "taxonomy_group": "",
            "desc": "Otolaryngology, Otolaryngology/Facial Plastic Surgery",
            "state": "OK",
            "license": "3296",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE GROUP NUMBER",
            "identifier": "DA5295",
            "state": "OK"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE PIN NUMBER",
            "identifier": "P00027981",
            "state": "OK"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200000030A",
            "state": "OK"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100257460A",
            "state": "OK"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Cherokee Nation Home Health Services, Inc. (Hospice of the Cherokee)
• Cherokee Nation Outpatient Health Center Pharmacy (W.W. Hastings Indian Hospital)
• Cherokee Wound Care
• Megan Lilly CHI
• Elizabeth Childers, BSN, RN
• Alyssa Childs
• Brittany Rashel Childs
• Karen Childs
• Ivanne Lynne Chiovoloni, PHARM.D., NCPS, BCPS
• Mkena Nicole Chitwood

• Otolaryngology/Facial Plastic Surgery Physician in Tahlequah, OK
• Providers in Tahlequah, OK by specialty
• Otolaryngology/Facial Plastic Surgery Physician in Oklahoma

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 28, 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.