John William Tracy, MD
Individual provider Active NPI Family Medicine Physician · Fancy Gap, VA
NPI 1265409288 · NPPES record last updated Jan 7, 2008
Key facts
- NPI
- 1265409288
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Family Medicine Physician 207Q00000X
- License
- 0101236128 (VA)
- Practice address
- 1661 Turner Spur Rd
Fancy Gap, VA 24328-4365 - Phone
- (276) 728-7212
- Fax
- (276) 728-5348
- NPI assigned
- Mar 8, 2006
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 1
Hospital & facility affiliations 6
Medicare Care Compare profile
- Specialty
- Family Practice
- Education
- University of North Carolina at Chapel Hill School of Medicine, 1982
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
Practice addresses (Care Compare)
108 Straight Away Lane
Laurel Fork, VA 24352-3988
108 Straight Away LN
Laurel Fork, VA 24352-3988
1205 Stone Mountain Rd
Laurel Fork, VA 24352-4058
Phone (276) 398-2532
Hospital & facility affiliations
- Blue Ridge Home Health Care
- Access Home Health Care and Rehabilitation
- Twin County Regional Hospital
- Northern Regional Hospital
- Wythe County Community Hospital
Merit-based Incentive Payment System (MIPS)
- Final score
- 23.68 of 100
- Quality
- 0
- Improvement activities
- 0
- Cost
- 78.92
Procedures performed for Medicare patients
| Procedure | Number of procedures |
|---|---|
| Removal of skin lesions | 20 |
| Removal of nail tissue | 1-10 |
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in VA
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20050208001072 | VA | Practitioner - Family Practice | 9032160940 | Practice locations: Laurel Fork, VA |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 11623 | NC | MD | Mental Health Counselor |
| 27408 | NC | MD | Pharmacist |
| 0101236128 | VA | MD | Family Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Laurel Fork Family Practice | Family Medicine | Past | Accepting new patients |
Interoperability endpoints
- fancygapfamilypractice.johntracy@126094.advancedmd-direct.com
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | 0101236128 | VA | Yes |
Addresses
Primary practice location
1661 Turner Spur Rd
Fancy Gap, VA 24328-4365
Mailing address
1661 Turner Spur Rd
Fancy Gap, VA 24328-4365
Phone (276) 728-7212
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 010137551 | Medicaid | VA | |
| 0101236128 | Other | VA | LICENSE |
Other providers in Fancy Gap, VA
- Fancy Gap Internal Medicine
- H & S Enterprises, Inc.
- Susan Lee Jones
- Allison Mitchell
- Susan Tracy Roberts
All providers in Fancy Gap, VA · Family Medicine Physician in Virginia
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jan 7, 2008. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.