NPIMap

Individual provider Active NPI

Jodi Tracy

  • Family Nurse Practitioner
  • North Conway, NH
National Provider Identifier
1235638057
Registry record updated Mar 17, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
069932-23 Issued in NH
Practice address
3073 White Mountain Hwy
North Conway, NH 03860-7101
Phone
(603) 356-5461
NPI assigned
Feb 7, 2018
Last updated
Mar 17, 2018By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 17, 2018

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 069932-23 NH Primary

Addresses

Primary practice location

3073 White Mountain Hwy
North Conway, NH 03860-7101

Mailing address

178 Sawyer Lake Rd
Gilmanton, NH 03237

Other practice location 1

178 Sawyer Lake Rd
Gilmanton, NH 03237
Phone (603) 254-5106

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NH
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
I20180405001870 NH Practitioner - Nurse Practitioner 9537422431 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Littleton Hospital AssociationGroup PAC ID 6901796556, 111 clinicians

Practice addresses (Care Compare)

580 Saint Johnsbury Rd
Littleton, NH 03561-3437
Phone (603) 444-7070

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
069932-23NHMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Littleton Hospital Association CurrentSince May 27, 2019 Accepting new patients
Littleton Hospital Association Current Accepting new patients
Littleton Hospital Association CurrentSince May 27, 2019 Accepting new patients
Littleton Hospital Association Past Accepting new patients

Locations

580 Saint Johnsbury Rd
Littleton, NH 03561
Phone (603) 444-0385

600 Saint Johnsbury Rd
Littleton, NH 03561
Phone (603) 444-9000

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

Hospital & facility affiliations 7

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

NPI Registry JSON

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

{
    "created_epoch": "1517961600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1521244800000",
    "number": "1235638057",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "178 SAWYER LAKE RD",
            "city": "GILMANTON",
            "state": "NH",
            "postal_code": "03237"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3073 WHITE MOUNTAIN HWY",
            "city": "NORTH CONWAY",
            "state": "NH",
            "postal_code": "038607101",
            "telephone_number": "603-356-5461"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "178 Sawyer Lake Rd",
            "address_purpose": "LOCATION",
            "city": "Gilmanton",
            "state": "NH",
            "postal_code": "03237",
            "country_code": "US",
            "telephone_number": "603-254-5106",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "TRACY",
        "first_name": "JODI",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-02-07",
        "last_updated": "2018-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NH",
            "license": "069932-23",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in North Conway, NH

Sources for this page

Verify at the official NPI Registry.