Tracy Lynn Dickison, CNS

Primary specialty

Gerontology Clinical Nurse SpecialistTaxonomy code 364SG0600X

License

CNS0448 Issued in MN

Practice address

400 E 3Rd St
Essentia Health Duluth Clinic
Duluth, MN 55805

Phone

(218) 786-8364

NPI assigned

Jan 24, 2013

Last updated

Jun 14, 2018By the provider in NPPES

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

Other identifiers 2

Other names 1

• Tracy Lynn Kuras Other name

Medicare fee-for-service enrollment

Enrolled in MN

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

Certified Clinical Nurse Specialist (CNS)

Education

Other, 2012

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Integrated Wound Care Minnesota PLLCGroup PAC ID 2769722511, 14 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Certified Nurse Specialist

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Integrated Wound Care Minnesota PLLC

  • General Practice Physician
  • Delano, MN
  • NPI 1205390457
  Medicare reassignment Care Compare group NPD
• The Duluth Clinic LTD

  dba Essentia Health Cloquet Clinic

  • Multi-Specialty Clinic/Center
  • Cloquet, MN
  • NPI 1902563638
  Medicare reassignment

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

{
    "created_epoch": "1358985600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1528934400000",
    "number": "1225376338",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "400 E 3RD ST",
            "address_2": "ESSENTIA HEALTH DULUTH CLINIC",
            "city": "DULUTH",
            "state": "MN",
            "postal_code": "558051951",
            "telephone_number": "218-786-8364"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "400 E 3RD ST",
            "address_2": "ESSENTIA HEALTH DULUTH CLINIC",
            "city": "DULUTH",
            "state": "MN",
            "postal_code": "55805",
            "telephone_number": "218-786-8364"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DICKISON",
        "first_name": "TRACY",
        "middle_name": "LYNN",
        "credential": "CNS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-01-24",
        "last_updated": "2018-06-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "364SG0600X",
            "taxonomy_group": "",
            "desc": "Clinical Nurse Specialist, Gerontology",
            "state": "MN",
            "license": "R161111-3",
            "primary": false
        },
        {
            "code": "364SG0600X",
            "taxonomy_group": "",
            "desc": "Clinical Nurse Specialist, Gerontology",
            "state": "MN",
            "license": "CNS0448",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1225376338",
            "state": "MN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1225376338",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "TRACY",
            "last_name": "KURAS",
            "middle_name": "LYNN",
            "credential": "CNS",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Tabitha Elizabeth Diamond
• Jenna Marie Dian, APRN, CNP
• Daniel Bruno Diaz, DO
• Josefino Calibo Diaz
• Sarah Elizabeth Diaz, DO
• Emily Rose Diekmann, RD, LD
• Sheila Diep
• Erika Jayne Dierker Birchhill, PA
• Charlene Schneider Dillon
• Molly Dirks, MHPR

• Gerontology Clinical Nurse Specialist in Duluth, MN
• Providers in Duluth, MN by specialty
• Gerontology Clinical Nurse Specialist in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 14, 2018; 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.