Tracy Nickol Connor, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

10332 Issued in AZ

Practice address

1910 S Stapley Dr Ste 209
Mesa, AZ 85204-6679

Phone

(480) 351-8020

Fax

(704) 355-7626

NPI assigned

Jun 21, 2007

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

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in CO, AZ2 enrollments

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 2

Specialty

Physician Assistant

Education

Univ of Nebraska Medical Center, Col of Dentistry, 2012

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Family Care Center LLC 703 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Family Care Center, LLC

  • Psychiatry Physician
  • Mesa, AZ
  • NPI 1598535288

  AZ, Physician Assistant

  Medicare reassignment Care Compare group NPD
• Family Care Center, LLC

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Colorado Springs, CO
  • NPI 1790141984

  CO, Family Medicine

  Medicare reassignment Care Compare group NPD
• Family Care Center LLC,

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Round Rock, TX
  • NPI 1427786482
  Care Compare group
• Family Care Center, LLC

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Franklin, TN
  • NPI 1124756085
  Care Compare group
• Family Care Center, LLC

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Tampa, FL
  • NPI 1689441255
  Care Compare group

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

{
    "created_epoch": "1182384000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1738540800000",
    "number": "1104022896",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1910 S STAPLEY DR STE 209",
            "city": "MESA",
            "state": "AZ",
            "postal_code": "852046679",
            "telephone_number": "480-351-8020",
            "fax_number": "704-355-7626"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1910 S STAPLEY DR STE 209",
            "city": "MESA",
            "state": "AZ",
            "postal_code": "852046679",
            "telephone_number": "480-351-8020",
            "fax_number": "704-355-7626"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CONNOR",
        "first_name": "TRACY",
        "middle_name": "NICKOL",
        "name_prefix": "Mrs.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-06-21",
        "last_updated": "2025-02-03",
        "certification_date": "2025-01-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "AZ",
            "license": "10332",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0596PA",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Haley Connelly
• Lisa Dianne Connelly, MA
• Russ Conner, PHARMD
• Kelly F Connor, PA-C
• Lin Connor
• Sharon Lee Connour, LCSW
• Tanner Conover, PT, DPT
• Jeremy Larkin Conoway, PTA
• Sharon A Conrad
• David S Conroy, PH.D.

• All providers in Mesa, AZ
• Physician Assistant in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 3, 2025; 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.