Active NPI
Tracy Lynne Burke
- Nurse Practitioner
- Brandon, FL
National Provider Identifier
1194360289
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Nurse Practitioner
- License
- 11003982
- Practice address
- 308 Brandon Town Center Mall
Brandon, FL 33511-4722 - Phone
- (813) 774-5772
- NPI assigned
- Nov 12, 2019
- Sex
- Female
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Nurse Practitioner | 363L00000X | 11003982 | FL | Primary |
Addresses
Primary practice location
308 Brandon Town Center Mall
Brandon, FL 33511-4722
Mailing address
308 Brandon Town Center Mall
Brandon, FL 33511-4722
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: No
- Opted out of Medicare
- Yes, effective Oct 25, 2025 through Oct 25, 2027
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 11003982 | FL | MD | Nurse Practitioner |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1573516800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1573516800000",
"number": "1194360289",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "308 BRANDON TOWN CENTER MALL",
"city": "BRANDON",
"state": "FL",
"postal_code": "335114722"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "308 BRANDON TOWN CENTER MALL",
"city": "BRANDON",
"state": "FL",
"postal_code": "335114722",
"telephone_number": "813-774-5772"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BURKE",
"first_name": "TRACY",
"middle_name": "LYNNE",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2019-11-12",
"last_updated": "2019-11-12",
"status": "A"
},
"taxonomies": [
{
"code": "363L00000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner",
"state": "FL",
"license": "11003982",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Brandon, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 12, 2019; 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; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.