Individual provider Active NPI

Tracy D Gregory, FNP-C

  • Family Nurse Practitioner
  • Dickson, TN
National Provider Identifier
1285977322
Registry record updated Nov 5, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
16882 Issued in TN
Practice address
127 Crestview Park Dr Ste 112
Dickson, TN 37055-2854
Phone
(615) 441-4533
Fax
(615) 441-4593
NPI assigned
Mar 27, 2013
Last updated
Nov 5, 2021By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 5, 2021

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 16882 TN Primary

Addresses

Primary practice location

127 Crestview Park Dr Ste 112
Dickson, TN 37055-2854

Mailing address

127 Crestview Park Dr Ste 209
Dickson, TN 37055-2856
Phone (615) 446-5121

Other identifiers 2

IdentifierTypeStateIssuer
T06867AOtherTNMEDICARE
1533948MedicaidTN

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: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20190214000562 TN Practitioner - Nurse Practitioner 6204065105 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Dickson Medical Associates, PCGroup PAC ID 3971408774, 55 clinicians
Select Physical Therapy Holdings IncGroup PAC ID 9537076401, shared by 76 NPIs, 1,992 clinicians

Practice addresses (Care Compare)

127 Crestview Park Dr
Dickson, TN 37055-2855
Phone (615) 446-5121

980 Professional Park Dr
Suite D
Clarksville, TN 37040-5251
Phone (931) 221-9967

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
16882TNMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Dickson Medical Associates PC CurrentSince Jan 28, 2019 Accepting new patients
Dickson Medical Associates, PC CurrentSince Jan 28, 2019 Accepting new patients

Locations

127 Crestview Park Dr
Dickson, TN 37055
Phone (615) 441-4478

127 Crestview Park Dr
Ste 112
Dickson, TN 37055
Phone (615) 441-4533

127 Crestview Park Dr
Ste 209
Dickson, TN 37055

758 Highway 46 S
Dickson, TN 37055
Phone (615) 446-2708

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": "1364342400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1636070400000",
    "number": "1285977322",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "127 CRESTVIEW PARK DR STE 209",
            "city": "DICKSON",
            "state": "TN",
            "postal_code": "370552856",
            "telephone_number": "615-446-5121",
            "fax_number": "615-446-1357"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "127 CRESTVIEW PARK DR STE 112",
            "city": "DICKSON",
            "state": "TN",
            "postal_code": "370552854",
            "telephone_number": "615-441-4533",
            "fax_number": "615-441-4593"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GREGORY",
        "first_name": "TRACY",
        "middle_name": "D",
        "credential": "FNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-03-27",
        "last_updated": "2021-11-05",
        "certification_date": "2021-11-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TN",
            "license": "16882",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE",
            "identifier": "T06867A",
            "state": "TN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1533948",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Dickson, TN

Sources for this page

Verify at the official NPI Registry.