Individual provider Active NPI

Tracy Martin Reece, D.O.

  • Emergency Medicine Physician
  • Johnson City, TN
National Provider Identifier
1083808885
Registry record updated Feb 9, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
2011 Issued in TN
Practice address
611 Toll Branch Rd
Johnson City, TN 37601-5283
Phone
(423) 773-9721
Fax
(423) 743-2884
NPI assigned
Sep 5, 2007
Last updated
Feb 9, 2011By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 9, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X 2011 TN Primary

Addresses

Primary practice location

611 Toll Branch Rd
Johnson City, TN 37601-5283

Mailing address

611 Toll Branch Rd
Johnson City, TN 37601-5283
Phone (423) 773-9721

Other identifiers 2

IdentifierTypeStateIssuer
1511260MedicaidTN
7100078890MedicaidKY

Other names 1

  • Marty Reece Other name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

State licenses

LicenseStateTypeSpecialty
2011TNMDEmergency Medicine Physician

NPI Registry JSON

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

{
    "created_epoch": "1188950400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1297209600000",
    "number": "1083808885",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "611 TOLL BRANCH RD",
            "city": "JOHNSON CITY",
            "state": "TN",
            "postal_code": "376015283",
            "telephone_number": "423-773-9721",
            "fax_number": "423-743-2884"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "611 TOLL BRANCH RD",
            "city": "JOHNSON CITY",
            "state": "TN",
            "postal_code": "376015283",
            "telephone_number": "423-773-9721",
            "fax_number": "423-743-2884"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "REECE",
        "first_name": "TRACY",
        "middle_name": "MARTIN",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-09-05",
        "last_updated": "2011-02-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "TN",
            "license": "2011",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1511260",
            "state": "TN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7100078890",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MARTY",
            "last_name": "REECE",
            "credential": "D.O.",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Johnson City, TN

Sources for this page

Verify at the official NPI Registry.