Tracy Ann Iversen, PMHNP

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

209029712 Issued in IL

Practice address

724 E Carroll St
Macomb, IL 61455-2454

Phone

(309) 249-0604

Fax

(309) 233-8272

NPI assigned

May 17, 2024

Last updated

Oct 13, 2026By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in IL

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

Specialty

Nurse Practitioner

Education

Other, 2023

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Graham Hospital AssociationGroup PAC ID 2769375021, 124 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Graham Hospital Association Hospital, Canton, IL, CCN 140001

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

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.

• Graham Hospital Association

  • Critical Access Hospital
  • Canton, IL
  • NPI 1780692087
  Medicare reassignment Care Compare group NPD
• Graham Hospital Association

  dba Knox & Fulton County Wound and Hyperbaric Medicine

  • Internal Medicine Physician
  • Galesburg, IL
  • NPI 1710845854
  NPD
• Graham Hospital Association

  dba Graham Medical Group Macomb

  • Family Medicine Physician
  • Macomb, IL
  • NPI 1780321117
  NPD

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

{
    "created_epoch": "1715904000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1791849600000",
    "number": "1063261345",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "724 E CARROLL ST",
            "city": "MACOMB",
            "state": "IL",
            "postal_code": "614552454",
            "telephone_number": "309-249-0604",
            "fax_number": "309-233-8272"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "724 E CARROLL ST",
            "city": "MACOMB",
            "state": "IL",
            "postal_code": "614552454",
            "telephone_number": "309-249-0604",
            "fax_number": "309-233-8272"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "IVERSEN",
        "first_name": "TRACY",
        "middle_name": "ANN",
        "credential": "PMHNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-05-17",
        "last_updated": "2026-10-13",
        "certification_date": "2026-10-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "IL",
            "license": "209029712",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Idol R Mitchell DPM PC
• Illinois Medicaid-Substance Abuse Macomb
• Erika Dawn Ingolia, BCABA
• Isabelo Castillo, MDSC
• Daphne Isme, FNP-C
• Richard Bruce Iverson, MD
• Vicki Ann Jobe-Crosby, LCPC
• Rosemary Irene John, CRSS, CADC
• Mona S Johnston, PHD
• Stephany Wilson Joy-Newman, ED.D., LCPC

• Psychiatric/Mental Health Nurse Practitioner in Macomb, IL
• Providers in Macomb, IL by specialty
• Psychiatric/Mental Health Nurse Practitioner in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 13, 2026; 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.