Individual provider Active NPI

Tracey Kizer, NP

  • Nurse Practitioner
  • Union City, TN
National Provider Identifier
1124027560
Registry record updated May 1, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
APN6842 Issued in TN
Practice address
700 Sherrill St
Suite B
Union City, TN 38261-5891
Phone
(731) 884-3900
Fax
(731) 884-3901
NPI assigned
Jul 19, 2005
Last updated
May 1, 2012By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 1, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X APN6842 TN Primary

Addresses

Primary practice location

700 Sherrill St
Suite B
Union City, TN 38261-5891

Mailing address

700 Sherrill St
Suite B
Union City, TN 38261-5891
Phone (731) 884-3900

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TN
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

Enrollment IDStateProvider typePAC IDDetails
I20080401000116 TN Practitioner - Nurse Practitioner 7315023371 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 1997
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Dyersburg Family Walk-in ClinicGroup PAC ID 5991793879, 24 clinicians

Practice addresses (Care Compare)

1516 E Reelfoot Ave
Union City, TN 38261-5850
Phone (731) 886-8662

2017 St John Ave B
Dyersburg, TN 38024-2209
Phone (731) 285-6110

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
6842TNMDPharmacist
APN6842TNMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Dyersburg Family Walk-in Clinic LLC CurrentSince Jan 29, 2020 Accepting new patients
Upperline Healthcare, PC CurrentSince Sep 1, 2025 Accepting new patients
Upperline Healthcare, PC Nurse Practitioner CurrentSince Sep 1, 2025 Accepting new patients

Locations

7348 E Brainerd Rd
Chattanooga, TN 37421
Phone (205) 822-8038

1954 Saint John Ave
Ste 1
Dyersburg, TN 38024
Phone (731) 285-6110

2017 Saint John Ave
Ste B
Dyersburg, TN 38024
Phone (731) 285-6110

Organizations & group practices 3

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 1

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": "1121731200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1335830400000",
    "number": "1124027560",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "700 SHERRILL ST",
            "address_2": "SUITE B",
            "city": "UNION CITY",
            "state": "TN",
            "postal_code": "382615891",
            "telephone_number": "731-884-3900",
            "fax_number": "731-884-3901"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "700 SHERRILL ST",
            "address_2": "SUITE B",
            "city": "UNION CITY",
            "state": "TN",
            "postal_code": "382615891",
            "telephone_number": "731-884-3900",
            "fax_number": "731-884-3901"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KIZER",
        "first_name": "TRACEY",
        "name_prefix": "Mrs.",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-07-19",
        "last_updated": "2012-05-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "TN",
            "license": "APN6842",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Union City, TN

Sources for this page

Verify at the official NPI Registry.