Tracy Nicole Daise, PHARM.D.

Primary specialty

PharmacistTaxonomy code 183500000X

License

RPH029076 Issued in GA

Practice address

3910 Buckthorne Dr Unit E
Orange Park, FL 32065-5643

Phone

(904) 236-9866

NPI assigned

Oct 4, 2016

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

HHS exclusion list flag

CMS’s directory marks this NPI as on an HHS exclusion list; no matching OIG record was found. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.

Credentials

Doctor of Pharmacy

State licenses

Practice roles

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.

• Waycross Family Pharmacy

  dba Rivers and Associates LLC

  • Pharmacist
  • Waycross, GA
  • NPI 1194010611
  NPD (past)

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

{
    "created_epoch": "1475539200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1601510400000",
    "number": "1205386141",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3910 BUCKTHORNE DR UNIT E",
            "city": "ORANGE PARK",
            "state": "FL",
            "postal_code": "320655643",
            "telephone_number": "904-236-9866"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3910 BUCKTHORNE DR UNIT E",
            "city": "ORANGE PARK",
            "state": "FL",
            "postal_code": "320655643",
            "telephone_number": "904-236-9866"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1303 Tebeau St",
            "address_purpose": "LOCATION",
            "city": "Waycross",
            "state": "GA",
            "postal_code": "315015318",
            "country_code": "US",
            "telephone_number": "912-548-0511",
            "fax_number": "912-548-0516",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DAISE",
        "first_name": "TRACY",
        "middle_name": "NICOLE",
        "credential": "PHARM.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-10-04",
        "last_updated": "2020-10-01",
        "certification_date": "2020-10-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "FL",
            "license": "PS37842",
            "primary": false
        },
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "GA",
            "license": "RPH029076",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "FL BOARD OF PHARMACY",
            "identifier": "PS37842",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GA BOARD OF PHARMACY",
            "identifier": "RPH029076",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Lauryn D'Amato
• Daniel Kao-Lyn Dagenhart, DO
• Kylie Daguio, DO
• Lyn Dahm, PTA
• Plasia Dailey
• Kyle Robert Gregorio Dajac, DO
• Conner Gerald Dalton
• Melanie A Daly
• Karen Lea Damm
• William George Damm

• Pharmacist in Orange Park, FL
• Providers in Orange Park, FL by specialty
• Pharmacist in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 1, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.