Tracy Michele Boller, APRN

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

4010008 Issued in KY

Practice address

132 Frontier Blvd Ste 103
Stanford, KY 40484-6516

Phone

(859) 287-2949

Fax

(855) 297-6367

NPI assigned

Sep 4, 2023

Last updated

Apr 14, 2025By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in KY

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

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: tracy.boller@1086371749298180.direct.elationemr.com

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.

• Kiosk Medicine Kentucky LLC

  • Family Nurse Practitioner
  • Louisville, KY
  • NPI 1205885035
  Medicare reassignment NPD
• Lakeside Primary Care, PSC

  • Rural Health Clinic/Center
  • Somerset, KY
  • NPI 1043790983

  Nurse Practitioner

  Medicare reassignment NPD
• Jomon Wellness LLC

  • Family Nurse Practitioner
  • Stanford, KY
  • NPI 1922853860
  NPD Authorized official

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

{
    "created_epoch": "1693785600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1744588800000",
    "number": "1316723539",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "132 FRONTIER BLVD STE 103",
            "city": "STANFORD",
            "state": "KY",
            "postal_code": "404846516",
            "telephone_number": "859-287-2949",
            "fax_number": "855-297-6367"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "132 FRONTIER BLVD STE 103",
            "city": "STANFORD",
            "state": "KY",
            "postal_code": "404846516",
            "telephone_number": "859-287-2949",
            "fax_number": "855-297-6367"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "200 Skywatch Dr",
            "address_purpose": "LOCATION",
            "city": "Danville",
            "state": "KY",
            "postal_code": "404222540",
            "country_code": "US",
            "telephone_number": "859-936-5630",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "6470 S Highway 27",
            "address_purpose": "LOCATION",
            "city": "Somerset",
            "state": "KY",
            "postal_code": "425016075",
            "country_code": "US",
            "telephone_number": "606-341-1339",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BOLLER",
        "first_name": "TRACY",
        "middle_name": "MICHELE",
        "name_prefix": "Mrs.",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-09-04",
        "last_updated": "2025-04-14",
        "certification_date": "2025-04-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "KY",
            "license": "401008",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "KY",
            "license": "4010008",
            "primary": true
        },
        {
            "code": "363LP2300X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Primary Care",
            "state": "KY",
            "license": "401008",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "KENTUCKY BOARD OF NURSING",
            "identifier": "4010008",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Lyndsey Bell
• Denise G Bernsen, MA
• Karen G Best, MA
• Abby Blanton, M.A. CCC-SLP
• Bluegrass Clinic Stanford, PLLC
• Kacie Danielle Brogle, RD
• Megan E Brown, LCSW
• Central Kentucky Diagnostic Center, LLC
• Central Kentucky Family Vision PLLC
• Jeanne A Chase, FNP

• Family Nurse Practitioner in Stanford, KY
• Providers in Stanford, KY by specialty
• Family Nurse Practitioner in Kentucky

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 14, 2025; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.