Tracy Fossas Burke

Primary specialty

Medical Physician AssistantTaxonomy code 363AM0700X

License

006353 Issued in GA

Practice address

5471 Chamblee Dunwoody Rd
Dunwoody, GA 30338-4114

Phone

(770) 481-0889

NPI assigned

Feb 23, 2012

Last updated

Feb 23, 2012By 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 GA

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

Practice roles

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.

• Good Samaritan Health Center of Cobb

  • Federally Qualified Health Center (FQHC)
  • Marietta, GA
  • NPI 1881923126
  Medicare reassignment
• Dunwoody Village Clinic, PC

  • Internal Medicine Physician
  • Dunwoody, GA
  • NPI 1457494502
  NPD (past)
• Summit Medical Group, Inc

  dba St. Elizabeth Physicians

  • Family Medicine Physician
  • Erlanger, KY
  • NPI 1750343216
  NPD (past)

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

{
    "created_epoch": "1329955200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1329955200000",
    "number": "1063785962",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5471 CHAMBLEE DUNWOODY RD",
            "city": "DUNWOODY",
            "state": "GA",
            "postal_code": "303384114",
            "telephone_number": "770-481-0889"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5471 CHAMBLEE DUNWOODY RD",
            "city": "DUNWOODY",
            "state": "GA",
            "postal_code": "303384114",
            "telephone_number": "770-481-0889"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BURKE",
        "first_name": "TRACY",
        "middle_name": "FOSSAS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-02-23",
        "last_updated": "2012-02-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "GA",
            "license": "006353",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jessie Emma Brutus-Darius, M.D.
• Katherine Burden
• Cheryl Burdette, ND
• Charles Bryan Burgess, MS, APC
• Elizabeth K Eversbusch Burke, DO
• Jason Bussey, MA, NCC, ABCP,
• Haley Dillon Byers, PHD
• C.E. Bailey, M.D., LLC
• Amber Elaine Calhoun
• Anne-Marie Campbell, D.C.

• Medical Physician Assistant in Dunwoody, GA
• Providers in Dunwoody, GA by specialty
• Medical Physician Assistant in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 23, 2012; 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.