Active NPI
Gregory Tracy, M.D.
- Pediatric Adolescent Medicine Physician
- Lexington, KY
National Provider Identifier
1154715159
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatric Adolescent Medicine Physician
- License
- 51121
- Practice address
- 3050 Harrodsburg Rd Ste 100
Lexington, KY 40503 - Phone
- (859) 277-6102
- NPI assigned
- Mar 27, 2015
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatric Adolescent Medicine Physician | 2080A0000X | 51121 | KY | Primary |
Addresses
Primary practice location
3050 Harrodsburg Rd Ste 100
Lexington, KY 40503
Mailing address
1221 S Broadway
Lexington, KY 40504-2701
Phone (859) 258-6200
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 7100430870 | Medicaid | KY |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in KY
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| New Lexington Clinic, PSC | Current | Accepting new patients | |
| New Lexington Clinic PSC | Current | Accepting new patients |
Locations
171 N Eagle Creek Dr
Ste 100
Lexington, KY 40509
Phone (859) 233-1490
3050 Harrodsburg Rd
Ste 100
Lexington, KY 40503
Phone (859) 277-6102
1221 S Broadway
Lexington, KY 40504
Phone (859) 258-4181
Interoperability endpoints
- gregory.tracy.1@13059.direct.athenahealth.com
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 and National Provider Directory roles.
-
- Multi-Specialty Clinic/Center
- Lexington, KY
- NPI 1700803681
-
- Clinical Medical Laboratory
- Lexington, KY
- NPI 1285409425
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1427414400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1704412800000",
"number": "1154715159",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1221 S BROADWAY",
"city": "LEXINGTON",
"state": "KY",
"postal_code": "405042701",
"telephone_number": "859-258-6200",
"fax_number": "859-258-6203"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3050 HARRODSBURG RD STE 100",
"city": "LEXINGTON",
"state": "KY",
"postal_code": "40503",
"telephone_number": "859-277-6102"
}
],
"practiceLocations": [],
"basic": {
"last_name": "TRACY",
"first_name": "GREGORY",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2015-03-27",
"last_updated": "2024-01-05",
"certification_date": "2024-01-05",
"status": "A"
},
"taxonomies": [
{
"code": "2080A0000X",
"taxonomy_group": "",
"desc": "Pediatrics, Adolescent Medicine",
"state": "KY",
"license": "51121",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "7100430870",
"state": "KY"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Lexington, KY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 5, 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.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.