Tracey Gillispie, NNP

Primary specialty

Neonatal Nurse PractitionerTaxonomy code 363LN0000X

License

95649 Issued in AZ

Practice address

300 W Clarendon Ave
375
Phoenix, AZ 85013-3420

Phone

(602) 277-4161

Fax

(602) 274-3394

NPI assigned

Jul 14, 2006

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

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in AZ

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

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: tgillispie27293@direct.valleywisehealth.org

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.

• Maricopa County Special Health Care District

  • General Acute Care Hospital
  • Phoenix, AZ
  • NPI 1073576740
  Medicare reassignment NPD
• Maricopa County Special Health Care District

  • Adult Mental Health Clinic/Center
  • Avondale, AZ
  • NPI 1043679327
  NPD
• Maricopa County Special Health Care District

  • Federally Qualified Health Center (FQHC)
  • Mesa, AZ
  • NPI 1306265145
  NPD
• Neonatology Associates, LTD

  • Ph.D. Medical Genetics
  • Phoenix, AZ
  • NPI 1275569501

  Neonatal

  NPD (past)

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

{
    "created_epoch": "1152835200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1063438828",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "300 W CLARENDON AVE",
            "address_2": "375",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850133420",
            "telephone_number": "602-277-4161",
            "fax_number": "602-274-3394"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "300 W CLARENDON AVE",
            "address_2": "375",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850133420",
            "telephone_number": "602-277-4161",
            "fax_number": "602-274-3394"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GILLISPIE",
        "first_name": "TRACEY",
        "credential": "NNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-14",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LN0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Neonatal",
            "state": "AZ",
            "license": "95649",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "703406",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• James P Gilligan, MSN, ACNP-BC
• Carissa Elizabeth Gilliland, M.ED., BCBA, LBA
• Jared Murphy Gilliland, DDS
• John E. Gillis, D.M.D.
• John Malcolm Gillis, DMD
• Kate M Gillpatrick, DO
• Eden Gillund
• Desiree Miller Gilman, M.S. CCC-SLP
• Ellen Deborah Gilman, M.D.
• Scott Gilman, PMHNP

• Neonatal Nurse Practitioner in Phoenix, AZ
• Providers in Phoenix, AZ by specialty
• Neonatal Nurse Practitioner in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.