Tracy Lynn Detwiler, PAC

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

50-002477 Issued in OH

Practice address

212 E Columbus Ave Ste 1
Bellefontaine, OH 43311-2033

Phone

(937) 599-1411

Fax

(937) 599-4128

NPI assigned

Nov 7, 2006

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

Electronic endpoints 4

Medicare fee-for-service enrollment

Enrolled in OH

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

Physician Assistant

Education

Other, 2009

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Community Health and Wellness Partners of Logan CountyGroup PAC ID 8022247469, 20 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: tracy.detwiler@chwplc.eclinicaldirectplus.com

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.

• Community Health & Wellness Partners of Logan County

  • Community Health Clinic/Center
  • West Liberty, OH
  • NPI 1689005357
  Medicare reassignment Care Compare group
• Community Health & Wellness Partners of Logan County

  • Student Health Clinic/Center
  • Saint Paris, OH
  • NPI 1205641388
  NPD
• Community Health & Wellness Partners of Logan County

  • Student Health Clinic/Center
  • Urbana, OH
  • NPI 1730782798
  NPD
• Community Health & Wellness Partners of Logan County

  • Student Health Clinic/Center
  • West Liberty, OH
  • NPI 1083215875
  NPD (past)
• Community Health & Wellness Partners of Logan County

  • Federally Qualified Health Center (FQHC)
  • Russells Point, OH
  • NPI 1962828293
  NPD (past)
• Community Health & Wellness Partners of Logan County

  • Community Health Clinic/Center
  • Bellefontaine, OH
  • NPI 1982360533
  NPD (past)
• Lima Memorial Joint Operating Company

  • General Acute Care Hospital
  • Lima, OH
  • NPI 1336144732
  NPD (past)
• Pathology Laboratories, Inc.

  • Clinical Medical Laboratory
  • Toledo, OH
  • NPI 1346285988
  NPD (past)

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

{
    "created_epoch": "1162857600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1701734400000",
    "number": "1154490738",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "212 E COLUMBUS AVE",
            "city": "BELLEFONTAINE",
            "state": "OH",
            "postal_code": "433112033",
            "telephone_number": "937-599-1411",
            "fax_number": "937-599-4128"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "212 E COLUMBUS AVE STE 1",
            "city": "BELLEFONTAINE",
            "state": "OH",
            "postal_code": "433112033",
            "telephone_number": "937-599-1411",
            "fax_number": "937-599-4128"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DETWILER",
        "first_name": "TRACY",
        "middle_name": "LYNN",
        "credential": "PAC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-11-07",
        "last_updated": "2023-12-05",
        "certification_date": "2023-12-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "OH",
            "license": "50-002477",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "tracy.detwiler@chwplc.eclinicaldirectplus.com",
            "affiliation": "N",
            "address_1": "212 E Columbus Ave Ste 1",
            "city": "Bellefontaine",
            "state": "OH",
            "country_code": "US",
            "postal_code": "433112033",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "tracy.detwiler@chwplc.eclinicaldirectplus.com",
            "affiliation": "N",
            "address_1": "4879 US Highway 68 S",
            "city": "West Liberty",
            "state": "OH",
            "country_code": "US",
            "postal_code": "433579525",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "tracy.detwiler@chwplc.eclinicaldirectplus.com",
            "affiliation": "N",
            "address_1": "8200 State Route 366 Ste 1",
            "city": "Russells Point",
            "state": "OH",
            "country_code": "US",
            "postal_code": "433489670",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "tracy.detwiler@chwplc.eclinicaldirectplus.com",
            "affiliation": "N",
            "address_1": "7208 US Highway 68 N Ste 2",
            "city": "West Liberty",
            "state": "OH",
            "country_code": "US",
            "postal_code": "433579663",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Destiny Nichole Daniels
• Thomas E. Darrah, D.O.
• Chasity Ann Defibaugh
• Austin Deneff
• Mary Deskins
• Donald Devine
• Julie Devine, APRN-CNP
• Seema S Dhingra, DDS MSD
• Abigail Dillon, CCC-SLP
• Kathleen Jean Doup-Troyer, D.C.

• Physician Assistant in Bellefontaine, OH
• Providers in Bellefontaine, OH by specialty
• Physician Assistant in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 5, 2023; 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.