Tracey Ann Carpenter, NP-C

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

2016023933 Issued in MO

Practice address

232 S Woods Mill Rd Ste 400
Chesterfield, MO 63017-3467

Phone

(314) 878-2888

Fax

(314) 576-8167

NPI assigned

Nov 2, 2016

Last updated

Nov 2, 2016By 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 2

Addresses

Other names 1

• Miss Tracey Ann Broadwater Former name

Medicare fee-for-service enrollment

Enrolled in MO

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, 2016

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Neurosurgery and Neurology LLCGroup PAC ID 2769412246, 13 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• St Lukes Hospital Hospital, Chesterfield, MO, CCN 260179

Merit-based Incentive Payment System (MIPS)

Final score

92.71 of 100Reported as apm

Quality

82.25

Promoting interoperability

100

Improvement activities

40

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.

• Neurosurgery and Neurology LLC

  • Specialist
  • Chesterfield, MO
  • NPI 1134291388
  Medicare reassignment Care Compare group
• Atc, LLC

  dba Lynette Santos Malik, MD

  • Pain Medicine (Physical Medicine & Rehabilitation) Physician
  • Chesterfield, MO
  • NPI 1700980380
  NPD (past)

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

• St. Lukes Episcopal-Presbyterian Hospital

  dba St. Luke's Hospital

  • General Acute Care Hospital
  • Chesterfield, MO
  • NPI 1346251543
  Care Compare affiliation

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

{
    "created_epoch": "1478044800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1478044800000",
    "number": "1083166433",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "622 DARTMOUTH CREST DR",
            "city": "WILDWOOD",
            "state": "MO",
            "postal_code": "630115433",
            "telephone_number": "636-284-0263"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "232 S WOODS MILL RD STE 400",
            "city": "CHESTERFIELD",
            "state": "MO",
            "postal_code": "630173467",
            "telephone_number": "314-878-2888",
            "fax_number": "314-576-8167"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CARPENTER",
        "first_name": "TRACEY",
        "middle_name": "ANN",
        "name_prefix": "Mrs.",
        "credential": "NP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-11-02",
        "last_updated": "2016-11-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "MO",
            "license": "2016023933",
            "primary": true
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MO",
            "license": "2016023933",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "TRACEY",
            "last_name": "BROADWATER",
            "middle_name": "ANN",
            "prefix": "MISS",
            "credential": "RN",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Justine L Carlson, LCSW
• Cheri M Carmody, RN BC ANP
• Bradley Ross Carn, D.M.D., MD
• Carole Myre Counseling LLC
• Carolynn F Wolff DMD PC
• Lisa Ann Carr, SPEECH PATHOLOGIST,
• Oscar A Cartaya, M.D.
• Angela Cartwright, D.O.
• Brenda Lee Casey, MSW LCSW
• Katie Rose Casey, NP-C

• Nurse Practitioner in Chesterfield, MO
• Providers in Chesterfield, MO by specialty
• Nurse Practitioner in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 2, 2016; 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.