NPIMap

Individual provider Active NPI

Tracy L Christensen, PA C

  • Physician Assistant
  • Dunn, NC
National Provider Identifier
1336140235
Registry record updated Nov 18, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
103714 Issued in NC
Practice address
721Tilghman Dr
Ste 100
Dunn, NC 28334-5519
Phone
(910) 891-4202
Fax
(910) 891-2602
NPI assigned
Aug 2, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 18, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 103714 NC Primary

Addresses

Primary practice location

721Tilghman Dr
Ste 100
Dunn, NC 28334-5519

Mailing address

721 Tilghman Dr
Ste 100
Dunn, NC 28334-6063
Phone (910) 891-4202

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040412000210 NC Practitioner - Physician Assistant 0244224574 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
University of Utah School of Medicine, 1998
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Integrated Wound Specialists of North Carolina, PLLCGroup PAC ID 7810172616, 17 clinicians

Practice addresses (Care Compare)

35 Memorial Dr
Pinehurst, NC 28374-8708
Phone (910) 715-5901

803 Tilghman Dr
Suite 300
Dunn, NC 28334-6699
Phone (910) 230-7858

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
103714NCMDPhysician Assistant

Interoperability endpoints

  • Direct secure messaging: tchristensen115854@firsthealth.direct-ci.net
  • Direct secure messaging: tchristensen102010@capefearvalley.direct-ci.com

Organizations & group practices 1

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.

Hospital & facility affiliations 8

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": "1122940800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1416268800000",
    "number": "1336140235",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "721 TILGHMAN DR",
            "address_2": "STE 100",
            "city": "DUNN",
            "state": "NC",
            "postal_code": "283346063",
            "telephone_number": "910-891-4202",
            "fax_number": "910-891-2602"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "721TILGHMAN DR",
            "address_2": "STE 100",
            "city": "DUNN",
            "state": "NC",
            "postal_code": "283345519",
            "telephone_number": "910-891-4202",
            "fax_number": "910-891-2602"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHRISTENSEN",
        "first_name": "TRACY",
        "middle_name": "L",
        "name_prefix": "Mr.",
        "credential": "PA C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-08-02",
        "last_updated": "2014-11-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NC",
            "license": "103714",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Dunn, NC

Sources for this page

Verify at the official NPI Registry.