Individual provider Active NPI

Courtney Tracy, CPNP-PC

  • Pediatric Nurse Practitioner
  • Dartmouth, MA
National Provider Identifier
1285332866
Registry record updated Feb 9, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Nurse PractitionerTaxonomy code 363LP0200X
License
RN2372175 Issued in MA
Practice address
531 Faunce Corner Rd
Dartmouth, MA 02747-1242
Phone
(508) 996-3991
NPI assigned
Feb 22, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 9, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Nurse Practitioner 363LP0200X 285516 AZ
Pediatric Nurse Practitioner 363LP0200X RN2372175 MA Primary

Addresses

Primary practice location

531 Faunce Corner Rd
Dartmouth, MA 02747-1242

Mailing address

535 Faunce Corner Rd
Dartmouth, MA 02747-1242
Phone (508) 996-3991

Other practice location 1

1400 W Valencia Rd Ste 110
Tucson, AZ 85746-6006
Phone (520) 751-3335

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA
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

Enrollment IDStateProvider typePAC IDDetails
I20231031002523 MA Practitioner - Nurse Practitioner 4789040213 Reassigns benefits to 2 organizations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Lifespan Physician Group of Massachusetts Inc CurrentSince Jan 1, 2025 Accepting new patients
Steward Medical Group, Inc CurrentSince Nov 6, 2023 Accepting new patients
Steward Medical Group, Inc CurrentSince Nov 6, 2023 Accepting new patients
Lifespan Corporation Current Accepting new patients
Steward Medical Group, Inc Past Accepting new patients
Arizona Community Physicians PC PastSince Mar 1, 2023 Accepting new patients

Locations

851 Middle St
Ste 2100
Fall River, MA 02721
Phone (508) 235-5445

535 Faunce Corner Rd
North Dartmouth, MA 02747
Phone (508) 961-0665

531 Faunce Corner Rd
North Dartmouth, MA 02747
Phone (508) 991-2255

Interoperability endpoints

  • Direct secure messaging: ctracy236206@brownhealth.medalliesdirect.net
  • Direct secure messaging: courtney.tracy.1@2017.direct.athenahealth.com

Organizations & group practices 6

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.

NPI Registry JSON

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

{
    "created_epoch": "1677024000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1707436800000",
    "number": "1285332866",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "535 FAUNCE CORNER RD",
            "city": "DARTMOUTH",
            "state": "MA",
            "postal_code": "027471242",
            "telephone_number": "508-996-3991"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "531 FAUNCE CORNER RD",
            "city": "DARTMOUTH",
            "state": "MA",
            "postal_code": "027471242",
            "telephone_number": "508-996-3991"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1400 W Valencia Rd Ste 110",
            "address_purpose": "LOCATION",
            "city": "Tucson",
            "state": "AZ",
            "postal_code": "857466006",
            "country_code": "US",
            "telephone_number": "520-751-3335",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "TRACY",
        "first_name": "COURTNEY",
        "name_prefix": "Mrs.",
        "credential": "CPNP-PC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-02-22",
        "last_updated": "2024-02-09",
        "certification_date": "2024-02-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "AZ",
            "license": "285516",
            "primary": false
        },
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "MA",
            "license": "RN2372175",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Dartmouth, MA

Sources for this page

Verify at the official NPI Registry.