Individual provider Active NPI

Tracy Alan Merrell, DPM

  • Podiatrist
  • Murfreesboro, TN
National Provider Identifier
1275515223
Registry record updated Dec 15, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
PodiatristTaxonomy code 213E00000X
License
000484 Issued in TN
Practice address
1747 Medical Center Pkwy
Suite 100
Murfreesboro, TN 37129-2563
Phone
(615) 848-1902
Fax
(615) 848-0721
NPI assigned
Nov 16, 2005
Last updated
Dec 15, 2021By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 15, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Podiatrist 213E00000X 000484 TN Primary

Addresses

Primary practice location

1747 Medical Center Pkwy
Suite 100
Murfreesboro, TN 37129-2563

Mailing address

925 S Church St
Ste A100
Murfreesboro, TN 37130-4958
Phone (615) 848-1902

Other identifiers 3

IdentifierTypeStateIssuer
4663010001OtherTNPALMETTO
3352573MedicaidTN
4038849OtherTNBCBS

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TN
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040407000402 TN Practitioner - Podiatry 7719970524 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Podiatry
Education
Other, 1994
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

925 S Church St
A100
Murfreesboro, TN 37130-4958
Phone (615) 848-1902

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
62.58 of 100Reported as group
Quality
13.2
Improvement activities
40

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of tissue96
Removal of nail tissue28

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
000484TNMDPodiatrist
484TNMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Dr. Tracy a. Merrell, D.P.M., P.C. CurrentSince Apr 1, 2003 Accepting new patients
Integrated Behavioral Health, Inc. Past Accepting new patients

Locations

1747 Medical Center Pkwy
Ste 100
Murfreesboro, TN 37129
Phone (615) 848-1902

925 S Church St
Ste A100
Murfreesboro, TN 37130
Phone (615) 848-1902

Organizations & group practices 2

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 2

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": "1132099200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1639526400000",
    "number": "1275515223",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "925 S CHURCH ST",
            "address_2": "STE A100",
            "city": "MURFREESBORO",
            "state": "TN",
            "postal_code": "371304958",
            "telephone_number": "615-848-1902",
            "fax_number": "615-848-0721"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1747 MEDICAL CENTER PKWY",
            "address_2": "SUITE 100",
            "city": "MURFREESBORO",
            "state": "TN",
            "postal_code": "371292563",
            "telephone_number": "615-848-1902",
            "fax_number": "615-848-0721"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MERRELL",
        "first_name": "TRACY",
        "middle_name": "ALAN",
        "credential": "DPM",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-11-16",
        "last_updated": "2021-12-15",
        "certification_date": "2021-12-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213E00000X",
            "taxonomy_group": "",
            "desc": "Podiatrist",
            "state": "TN",
            "license": "000484",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PALMETTO",
            "identifier": "4663010001",
            "state": "TN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3352573",
            "state": "TN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "4038849",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Murfreesboro, TN

Sources for this page

Verify at the official NPI Registry.