Individual provider Active NPI

Tracy Louise Page, M.D.,M.A.

  • Physical Medicine & Rehabilitation Physician
  • Appleton, WI
National Provider Identifier
1093972754
Registry record updated Jun 2, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Medicine & Rehabilitation PhysicianTaxonomy code 208100000X
License
64564-20 Issued in WI
Practice address
2801 E Enterprise Ave Ste 205
Appleton, WI 54913-8559
Phone
(920) 968-9311
NPI assigned
May 20, 2008
Last updated
Jun 2, 2021By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 2, 2021

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

Specialties & licenses 5

Specialty (taxonomy)CodeLicenseStatePrimary
Pain Medicine (Physical Medicine & Rehabilitation) Physician 2081P2900X 40852 AZ
Sports Medicine (Physical Medicine & Rehabilitation) Physician 2081S0010X 40852 AZ
Obesity Medicine (Preventive Medicine) Physician 2083B0002X 64564-20 WI
Public Health & General Preventive Medicine Physician 2083P0901X 64564-20 WI
Physical Medicine & Rehabilitation Physician 208100000X 64564-20 WI Primary

Addresses

Primary practice location

2801 E Enterprise Ave Ste 205
Appleton, WI 54913-8559

Mailing address

2801 E Enterprise Ave Ste 205
Appleton, WI 54913-8559
Phone (920) 968-9311

Other names 1

  • Dr. Tracy Louise Allen Former 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: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.
Opted out of Medicare
Yes, effective Jul 14, 2025 through Jul 14, 2027

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Arts, Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
40852AZMDSports Medicine (Physical Medicine & Rehabilitation) Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Tucson Orthopaedic Institute Professional Corporation Physical Medicine & Rehabilitation Past Accepting new patients

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1211241600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1622592000000",
    "number": "1093972754",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2801 E ENTERPRISE AVE STE 205",
            "city": "APPLETON",
            "state": "WI",
            "postal_code": "549138559",
            "telephone_number": "920-968-9311",
            "fax_number": "920-305-7411"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2801 E ENTERPRISE AVE STE 205",
            "city": "APPLETON",
            "state": "WI",
            "postal_code": "549138559",
            "telephone_number": "920-968-9311"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PAGE",
        "first_name": "TRACY",
        "middle_name": "LOUISE",
        "name_prefix": "Dr.",
        "credential": "M.D.,M.A.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-05-20",
        "last_updated": "2021-06-02",
        "certification_date": "2021-06-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2081P2900X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation, Pain Medicine",
            "state": "AZ",
            "license": "40852",
            "primary": false
        },
        {
            "code": "2081S0010X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation, Sports Medicine",
            "state": "AZ",
            "license": "40852",
            "primary": false
        },
        {
            "code": "2083B0002X",
            "taxonomy_group": "",
            "desc": "Preventive Medicine, Obesity Medicine",
            "state": "WI",
            "license": "64564-20",
            "primary": false
        },
        {
            "code": "2083P0901X",
            "taxonomy_group": "",
            "desc": "Preventive Medicine, Public Health & General Preventive Medicine",
            "state": "WI",
            "license": "64564-20",
            "primary": false
        },
        {
            "code": "208100000X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation",
            "state": "WI",
            "license": "64564-20",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "TRACY",
            "last_name": "ALLEN",
            "middle_name": "LOUISE",
            "prefix": "DR.",
            "credential": "M.D.,M.A.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Appleton, WI

Sources for this page

Verify at the official NPI Registry.