NPIMap

Individual provider Active NPI

Tracy Thomas Shreve, FNP

  • Family Nurse Practitioner
  • Spartanburg, SC
National Provider Identifier
1154787877
Registry record updated Apr 27, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
19945 Issued in SC
Practice address
1530 Drayton Road
Spartanburg, SC 29307
Phone
(864) 560-8777
NPI assigned
Jan 11, 2016
Last updated
Apr 27, 2020By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 27, 2020

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 19945 SC Primary

Addresses

Primary practice location

1530 Drayton Road
Spartanburg, SC 29307

Mailing address

PO Box 743070
Atlanta, GA 30374-3070

Other practice location 1

709 Mall Blvd
Savannah, GA 31406-4805
Phone (912) 201-8000

Other identifiers 2

IdentifierTypeStateIssuer
NP4503MedicaidSC
SCA1635019OtherSCMEDICARE PIN

Other names 1

  • Tracy Ann Thomas Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in SC
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20170511001352 SC Practitioner - Nurse Practitioner 8628372331 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Spartanburg Medical CenterGroup PAC ID 3072425297, 1,060 clinicians

Practice addresses (Care Compare)

1530 Drayton Rd
Spartanburg, SC 29307
Phone (864) 560-8777

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
94.7 of 100Reported as apm
Quality
89.4
Promoting interoperability
100
Improvement activities
40

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Spartanburg Medical Center CurrentSince Feb 26, 2023 Accepting new patients
Regenesis Organization Community Health Center Current Accepting new patients
Regenesis Organization Community Health Center CurrentSince Feb 22, 2017 Accepting new patients
Spartanburg Medical Center CurrentSince Feb 1, 2020 Accepting new patients
Integrated Medical Solutions of Knoxville Current Accepting new patients
Regenesis Organization Community Health Center CurrentSince Feb 22, 2017 Accepting new patients
Regenesis Organization Community Health Center Current Accepting new patients
Regenesis Organization Community Health Center Current Accepting new patients
Spartanburg Medical Center Current Accepting new patients
Spartanburg Medical Center CurrentSince Feb 1, 2020 Accepting new patients
Regenesis Organization Community Health Center Current Accepting new patients
Spartanburg Medical Center Past Accepting new patients

Locations

101 E Wood St
Ste 300
Spartanburg, SC 29303
Phone (864) 560-6554

750 S Church St
Spartanburg, SC 29306
Phone (864) 582-2829

853 N Church St
Ste 410A
Spartanburg, SC 29303
Phone (864) 560-6928

220 Irby St
Woodruff, SC 29388
Phone (864) 476-2731

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/JEHGBD

Organizations & group practices 12

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 6

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": "1452470400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1587945600000",
    "number": "1154787877",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 743070",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303743070"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1530 DRAYTON ROAD",
            "city": "SPARTANBURG",
            "state": "SC",
            "postal_code": "29307",
            "telephone_number": "864-560-8777"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "709 Mall Blvd",
            "address_purpose": "LOCATION",
            "city": "Savannah",
            "state": "GA",
            "postal_code": "314064805",
            "country_code": "US",
            "telephone_number": "912-201-8000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SHREVE",
        "first_name": "TRACY",
        "middle_name": "THOMAS",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-01-11",
        "last_updated": "2020-04-27",
        "certification_date": "2020-04-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "SC",
            "license": "19945",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "NP4503",
            "state": "SC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PIN",
            "identifier": "SCA1635019",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "TRACY",
            "last_name": "THOMAS",
            "middle_name": "ANN",
            "credential": "FNP",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Spartanburg, SC

Sources for this page

Verify at the official NPI Registry.