Tracey Nicole Skelton, FNP-C

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

906694 Issued in MS

Practice address

550 Craft St
Holly Springs, MS 38635-3255

Phone

(662) 274-3218

NPI assigned

Jun 12, 2024

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in MS

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, 2024

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Minor Med Care, LLCGroup PAC ID 7618866021, 77 clinicians

MDB Behavioral Health Services LLCGroup PAC ID 0749572915, 201 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Science, Nurse Practitioner

State licenses

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://fhir.meditouchehr.com/api/fhir/r4/

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.

• MDB Behavioral Health Services LLC

  • Rural Health Clinic/Center
  • Vicksburg, MS
  • NPI 1669835310

  MS

  Medicare reassignment Care Compare group NPD
• Minor Med Care, LLC

  • Primary Care Clinic/Center
  • Jackson, MS
  • NPI 1407968738

  MS

  Medicare reassignment Care Compare group NPD
• Heal All Wound Care LLC

  • Adult Health Nurse Practitioner
  • Flowood, MS
  • NPI 1093554982

  MS

  Medicare reassignment NPD
• Marshall Urgent Care

  • Family Nurse Practitioner
  • Holly Springs, MS
  • NPI 1588103246

  Family, MS

  Medicare reassignment NPD
• MDB Care Management LLC

  • Primary Care Nurse Practitioner
  • Flowood, MS
  • NPI 1144925272

  MS

  Medicare reassignment NPD
• Uppal Medical Center LLC

  • Rural Health Clinic/Center
  • Greenville, MS
  • NPI 1558927905

  MS

  Medicare reassignment NPD
• Minor Med Care, LLC

  • Rural Health Clinic/Center
  • Raymond, MS
  • NPI 1669575627
  NPD
• Heal All Wound Care LLC

  • Adult Health Nurse Practitioner
  • Jackson, MS
  • NPI 1477479384
  NPD (past)

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

{
    "created_epoch": "1718150400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1719532800000",
    "number": "1114769726",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2267 OLD HIGHWAY 78",
            "city": "HICKORY FLAT",
            "state": "MS",
            "postal_code": "386338219",
            "telephone_number": "662-544-1552"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "550 CRAFT ST",
            "city": "HOLLY SPRINGS",
            "state": "MS",
            "postal_code": "386353255",
            "telephone_number": "662-274-3218"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2267 Old Highway 78",
            "address_purpose": "LOCATION",
            "city": "Hickory Flat",
            "state": "MS",
            "postal_code": "386338219",
            "country_code": "US",
            "telephone_number": "662-544-1552",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SKELTON",
        "first_name": "TRACEY",
        "middle_name": "NICOLE",
        "credential": "FNP-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-06-12",
        "last_updated": "2024-06-28",
        "certification_date": "2024-06-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MS",
            "license": "906694",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Southeast Urology Network
• Gregory Thomas Stallworth, M.D.
• Jill McCallum Stephens, RPH

• All providers in Holly Springs, MS
• Family Nurse Practitioner in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 28, 2024; 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.