NPIMap

Individual provider Active NPI

Traci D Anderson, APRN

  • Family Nurse Practitioner
  • Glasgow, KY
National Provider Identifier
1093386740
Registry record updated Mar 1, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
3016283 Issued in KY
Practice address
310 N L Rogers Wells Blvd
Glasgow, KY 42141-1300
Phone
(270) 659-3398
Fax
(270) 651-1892
NPI assigned
Jul 5, 2021
Last updated
Mar 1, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 1, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 3016283 KY Primary

Addresses

Primary practice location

310 N L Rogers Wells Blvd
Glasgow, KY 42141-1300

Mailing address

310 N L Rogers Wells Blvd
Glasgow, KY 42141-1300
Phone (270) 651-1111

Other identifiers 1

IdentifierTypeStateIssuer
7100752180MedicaidKY

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address Traci.Anderson@tjrh.cernerdirect.com T J Samson Community Hospital

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KY
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20210806001626 KY Practitioner - Nurse Practitioner 1557765948 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
T J Samson Community HospitalGroup PAC ID 0648182600, 197 clinicians

Practice addresses (Care Compare)

310 N L Rogers Wells Blvd
Glasgow, KY 42141-1300
Phone (270) 651-1111

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
86.3 of 100Reported as group
Quality
74.59
Promoting interoperability
100
Improvement activities
40
Cost
68.87

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
T J Samson Community Hospital Family CurrentSince Jul 26, 2021 Accepting new patients
T J Samson Community Hospital Current Accepting new patients
T J Samson Community Hospital Family Current Accepting new patients
T J Samson Community Hospital Past Accepting new patients

Locations

1301 N Race St
Glasgow, KY 42141
Phone (270) 651-4141

310 N L Rogers Wells Blvd
Glasgow, KY 42141
Phone (270) 651-1111

Interoperability endpoints

  • Direct secure messaging: traci.anderson@tjrh.cernerdirect.com

Organizations & group practices 4

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.

Hospital & facility affiliations 4

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

NPI Registry JSON

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

{
    "created_epoch": "1625443200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1677628800000",
    "number": "1093386740",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "310 N L ROGERS WELLS BLVD",
            "city": "GLASGOW",
            "state": "KY",
            "postal_code": "421411300",
            "telephone_number": "270-651-1111",
            "fax_number": "270-651-1892"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "310 N L ROGERS WELLS BLVD",
            "city": "GLASGOW",
            "state": "KY",
            "postal_code": "421411300",
            "telephone_number": "270-659-3398",
            "fax_number": "270-651-1892"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ANDERSON",
        "first_name": "TRACI",
        "middle_name": "D",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-07-05",
        "last_updated": "2023-03-01",
        "certification_date": "2023-03-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "KY",
            "license": "3016283",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7100752180",
            "state": "KY"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "Traci.Anderson@tjrh.cernerdirect.com",
            "affiliation": "Y",
            "affiliationName": "T J Samson Community Hospital",
            "address_1": "310 N L Rogers Wells Blvd",
            "city": "Glasgow",
            "state": "KY",
            "country_code": "US",
            "postal_code": "421411300",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Glasgow, KY

Sources for this page

Verify at the official NPI Registry.