Mary Tracey

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

APN.0993060-NP Issued in CO

Practice address

52 Village Dr
Pagosa Springs, CO 81147-8368

Phone

(970) 264-2104

Fax

(970) 264-2108

NPI assigned

Apr 8, 2015

Last updated

Mar 17, 2018By the provider in NPPES

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

Medicare fee-for-service enrollment

Enrolled in CO

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, 2016

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

San Luis Valley Community Mental Health Center, Inc.Group PAC ID 0345267779, 34 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• San Luis Valley Community Mental Health Center, Inc.

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Alamosa, CO
  • NPI 1467289280
  Medicare reassignment Care Compare group NPD
• San Luis Valley Community Mental Health Center, Inc.

  dba San Luis Valley Behavioral Health Group

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Center, CO
  • NPI 1326865320
  NPD
• San Luis Valley Community Mental Health Center, Inc.

  dba San Luis Valley Behavioral Health Group

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Alamosa, CO
  • NPI 1891522645
  NPD
• San Luis Valley Community Mental Health Center, Inc.

  dba San Luis Valley Behavioral Health Group

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Alamosa, CO
  • NPI 1871320622
  NPD (past)
• San Luis Valley Community Mental Health Center, Inc.

  dba San Luis Valley Behavioral Health Group

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Alamosa, CO
  • NPI 1962239715
  NPD (past)

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

{
    "created_epoch": "1428451200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1521244800000",
    "number": "1134515984",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8745 COUNTY ROAD 9 S",
            "city": "ALAMOSA",
            "state": "CO",
            "postal_code": "811019610"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "52 VILLAGE DR",
            "city": "PAGOSA SPRINGS",
            "state": "CO",
            "postal_code": "811478368",
            "telephone_number": "970-264-2104",
            "fax_number": "970-264-2108"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "8745 County Road 9 S",
            "address_purpose": "LOCATION",
            "city": "Alamosa",
            "state": "CO",
            "postal_code": "811019610",
            "country_code": "US",
            "telephone_number": "719-589-3671",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "TRACEY",
        "first_name": "MARY",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-04-08",
        "last_updated": "2018-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "CO",
            "license": "APN.0993060-NP",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• The Rehab and Fitness Joint, Inc. (Fyzical Therapy and Balance Centers)
• Harold R Thompson, DMD
• William Frederick Thornell, D.D.S.
• Bonnie Sue Thrasher
• Roy Tinguely, MD
• Treeline Perspectives LLC
• Upper San Juan Health Service District (Pagosa Springs Medical Center)
• Upper San Juan Health Service District (Pagosa Springs Medical Center)
• Upper San Juan Health Service District (Pagosa Springs Medical Center)
• Upper San Juan Health Service District (Pagosa Springs Medical Center)

• Psychiatric/Mental Health Nurse Practitioner in Pagosa Springs, CO
• Providers in Pagosa Springs, CO by specialty
• Psychiatric/Mental Health Nurse Practitioner in Colorado

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 2018; 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.