Individual provider Active NPI

Tracy Novinger, APRN

  • Family Nurse Practitioner
  • Kirksville, MO
National Provider Identifier
1124918321
Registry record updated Jul 8, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
2025027322 Issued in MO
Practice address
1108 E Patterson St Ste 10
Kirksville, MO 63501-4043
Phone
(660) 956-0716
Fax
(660) 956-4119
NPI assigned
Jul 8, 2025
Last updated
Jul 8, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2025

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 2025027322 MO Primary

Addresses

Primary practice location

1108 E Patterson St Ste 10
Kirksville, MO 63501-4043

Mailing address

1108 E Patterson St Ste 10
Kirksville, MO 63501-4043
Phone (660) 956-0716

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MO
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
I20260110000217 MO Practitioner - Nurse Practitioner 3870079783 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2025
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Kirksville Clinic CorpGroup PAC ID 4486619269, 14 clinicians

Practice addresses (Care Compare)

800 W Jefferson St
Kirksville, MO 63501-1443
Phone (660) 626-2235

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2025027322MOMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Kirksville Specialty Clinic LLC Current Accepting new patients
Kirksville Clinic Corp CurrentSince Jan 5, 2026 Accepting new patients

Locations

1108 E Patterson St
Ste 10
Kirksville, MO 63501
Phone (660) 956-0487

800 W Jefferson St
Kirksville, MO 63501
Phone (660) 626-2235

Organizations & group practices 2

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": "1751932800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1751932800000",
    "number": "1124918321",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1108 E PATTERSON ST STE 10",
            "city": "KIRKSVILLE",
            "state": "MO",
            "postal_code": "635014043",
            "telephone_number": "660-956-0716",
            "fax_number": "660-956-4119"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1108 E PATTERSON ST STE 10",
            "city": "KIRKSVILLE",
            "state": "MO",
            "postal_code": "635014043",
            "telephone_number": "660-956-0716",
            "fax_number": "660-956-4119"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NOVINGER",
        "first_name": "TRACY",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-07-08",
        "last_updated": "2025-07-08",
        "certification_date": "2025-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MO",
            "license": "2025027322",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Kirksville, MO

Sources for this page

Verify at the official NPI Registry.