NPIMap

Individual provider Active NPI

Tracy M. Luther, FNP

  • Family Nurse Practitioner
  • Greenville, SC
National Provider Identifier
1164424222
Registry record updated May 20, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
APN0000011028 Issued in TN
Practice address
125 Halton Rd Ste 200
Greenville, SC 29607-3507
Phone
(864) 232-7338
NPI assigned
Aug 10, 2005
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 20, 2024

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 APN0000011028 TN Primary

Addresses

Primary practice location

125 Halton Rd Ste 200
Greenville, SC 29607-3507

Mailing address

PO Box 8676
Greenville, SC 29604-8676
Phone (864) 232-7338

Other identifiers 1

IdentifierTypeStateIssuer
3640092MedicaidTN

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
I20130705000521 SC Practitioner - Nurse Practitioner 3476593310 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2004
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Gastroenterology Associates, PAGroup PAC ID 1951215433, 57 clinicians

Practice addresses (Care Compare)

125 Halton Rd
Suite 200
Greenville, SC 29607-3507
Phone (864) 232-7338

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
11028TNMDDentist
APN0000011028TNMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Gastroenterology Associates, PA CurrentSince Jun 17, 2013 Accepting new patients
Gastroenterology Associates, PA CurrentSince Jun 17, 2013 Accepting new patients
Gastroenterology Associates, PA Past Accepting new patients
Northeast Tennessee Medical Associates PLC Past Accepting new patients

Locations

200 Fleetwood Dr
Easley, SC 29640
Phone (864) 442-7200

125 Halton Rd
Ste 200
Greenville, SC 29607

317 Saint Francis Dr
Ste 170
Greenville, SC 29601
Phone (864) 255-1886

3424 Augusta Rd
Ste 200
Greenville, SC 29605

200 Patewood Dr
Ste B200
Greenville, SC 29615
Phone (864) 454-2226

Organizations & group practices 4

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.

Hospital & facility affiliations 57

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

View all 57

NPI Registry JSON

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

{
    "created_epoch": "1123632000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1716163200000",
    "number": "1164424222",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 8676",
            "city": "GREENVILLE",
            "state": "SC",
            "postal_code": "296048676",
            "telephone_number": "864-232-7338",
            "fax_number": "864-239-6645"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "125 HALTON RD STE 200",
            "city": "GREENVILLE",
            "state": "SC",
            "postal_code": "296073507",
            "telephone_number": "864-232-7338"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LUTHER",
        "first_name": "TRACY",
        "middle_name": "M.",
        "name_prefix": "Ms.",
        "credential": "FNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2005-08-10",
        "last_updated": "2024-05-20",
        "certification_date": "2024-05-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TN",
            "license": "APN0000011028",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3640092",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Greenville, SC

Sources for this page

Verify at the official NPI Registry.