Tracey F Petrides, M.D.

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

17839 Issued in MS

Practice address

5779 Getwell Road
Building D, Suite 3
Southaven, MS 38672

Phone

(662) 510-6507

Fax

(662) 510-6508

NPI assigned

Aug 14, 2007

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in DE

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Psychiatry

Education

Uniformed Services Uhs Fe Hebert School of Med, 1996

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Christiana Care Health Services IncGroup PAC ID 9739097569, 1,480 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Christiana Hospital Hospital, Newark, DE, CCN 080001
• Bayhealth Medical Center, Kent Campus Hospital, Dover, DE, CCN 080004

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://fhir.meditouchehr.com/api/fhir/r4/

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.

• Christiana Care Health Services Inc

  • Family Medicine Physician
  • Wilmington, DE
  • NPI 1760811681
  Medicare reassignment Care Compare group NPD
• Xceptional Health & Wellness, PLLC.

  • Family Medicine Physician
  • Southaven, MS
  • NPI 1770857443
  NPD (past) Authorized official
• Christiana Care Health Services Inc

  • Neurology Physician
  • Chadds Ford, PA
  • NPI 1881228484
  NPD
• Family Medical Clinic of North Ms Inc

  • Family Medicine Physician
  • Southaven, MS
  • NPI 1134174154
  NPD (past)
• Christiana Care Health Services, Inc

  • Family Medicine Physician
  • Hockessin, DE
  • NPI 1134104565
  NPD (past)
• Magnolia Networks LLC

  • Internal Medicine Physician
  • Bridgeville, PA
  • NPI 1053774422
  NPD (past)

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

• Bayhealth Medical Center, Inc.

  • General Acute Care Hospital
  • Dover, DE
  • NPI 1467546135
  Care Compare affiliation
• Christiana Care Health Services, Inc.

  • General Acute Care Hospital
  • Wilmington, DE
  • NPI 1134194038
  Care Compare affiliation

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

{
    "created_epoch": "1187049600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1330387200000",
    "number": "1295927226",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5779 GETWELL ROAD",
            "address_2": "BUILDING D, SUITE 3",
            "city": "SOUTHAVEN",
            "state": "MS",
            "postal_code": "38672",
            "telephone_number": "662-510-6507",
            "fax_number": "662-510-6508"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5779 GETWELL ROAD",
            "address_2": "BUILDING D, SUITE 3",
            "city": "SOUTHAVEN",
            "state": "MS",
            "postal_code": "38672",
            "telephone_number": "662-510-6507",
            "fax_number": "662-510-6508"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PETRIDES",
        "first_name": "TRACEY",
        "middle_name": "F",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-08-14",
        "last_updated": "2012-02-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MS",
            "license": "17839",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Airreal Pegues, MS
• Madison Grace Pena, PTA
• Jennifer Petell, PH.D IN CLINICAL PSY
• Calleen Patricia Petersen, LMSW
• John S Petrides
• Blanche Foshee' Petty, APRN
• Pharmcare USA of Memphis, Inc
• Phase2 Labs Mississippi LLC
• Phillips County Transportation
• Galen Phillips, NP

• Family Medicine Physician in Southaven, MS
• Providers in Southaven, MS by specialty
• Family Medicine Physician in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 28, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.