Tracey Nutter

Primary specialty

Acute Care Nurse PractitionerTaxonomy code 363LA2100X

License

APN.0998714-NP Issued in CO

Practice address

4856 Innovation Dr
Fort Collins, CO 80525-5539

Phone

(970) 494-4200

Fax

(970) 613-4475

NPI assigned

Jan 30, 2020

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in TX

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Nurse Practitioner

Education

Other, 2019

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Revive PathwayGroup PAC ID 4284081639, 12 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

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.

• Revive Pathway

  • Substance Use Disorder Rehabilitation Clinic/Center
  • El Cajon, CA
  • NPI 1962117440

  TX

  Medicare reassignment Care Compare group
• Puyallup Tribal Opioid Clinic, Inc.

  • Substance Use Disorder Rehabilitation Clinic/Center
  • Tacoma, WA
  • NPI 1992582613

  TX

  Medicare reassignment NPD

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

{
    "created_epoch": "1580342400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1721779200000",
    "number": "1215568076",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4856 INNOVATION DR",
            "city": "FORT COLLINS",
            "state": "CO",
            "postal_code": "805255539",
            "telephone_number": "970-494-4200",
            "fax_number": "970-613-4475"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4856 INNOVATION DR",
            "city": "FORT COLLINS",
            "state": "CO",
            "postal_code": "805255539",
            "telephone_number": "970-494-4200",
            "fax_number": "970-613-4475"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NUTTER",
        "first_name": "TRACEY",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-01-30",
        "last_updated": "2024-07-24",
        "certification_date": "2024-07-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "CO",
            "license": "RN.1689615",
            "primary": false
        },
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "CO",
            "license": "APN.0998714-NP",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Nutrition and Cancer Connection, LLC
• Nutrition Game Plan LLC
• Devynn Nicole Nutt, MSW
• Joffrey Nutt
• Cecelia Nutter, RN
• Eric Mackenzie Nyberg, M.D.
• Krista Nyce, LPCC
• Cortnee Nye, BSW
• Alexandra Maria Nyman, LMT
• Tristan Nyman

• Acute Care Nurse Practitioner in Fort Collins, CO
• Providers in Fort Collins, CO by specialty
• Acute Care Nurse Practitioner in Colorado

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 24, 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.