Traci L Childress, APRN, PMHNP-BC

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

36836 Issued in TN

Practice address

1276 Gilbreath Dr
Johnson City, TN 37614-6503

Phone

(423) 439-1000

NPI assigned

Jun 12, 2024

Last updated

Nov 4, 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 1

Addresses

Medicare fee-for-service enrollment

Enrolled in TN, VA2 enrollments

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 2

Specialty

Nurse Practitioner

Education

Other, 2017

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Frontier Health

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Gray, TN
  • NPI 1720147408

  VA

  Medicare reassignment NPD
• Knoxville Center for Behavioral Medicine LLC

  • Psychiatric Hospital
  • Knoxville, TN
  • NPI 1710640776
  Medicare reassignment NPD
• Frontier Health

  dba Hancock County Mental Health Center

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Sneedville, TN
  • NPI 1053475558
  NPD

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

{
    "created_epoch": "1718150400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1762214400000",
    "number": "1376385005",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1167 SPRATLIN PARK DR",
            "city": "GRAY",
            "state": "TN",
            "postal_code": "376156205",
            "telephone_number": "423-467-3600",
            "fax_number": "423-467-3644"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1276 GILBREATH DR",
            "city": "JOHNSON CITY",
            "state": "TN",
            "postal_code": "376146503",
            "telephone_number": "423-439-1000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1570 Waverly Rd",
            "address_purpose": "LOCATION",
            "city": "Kingsport",
            "state": "TN",
            "postal_code": "376642523",
            "country_code": "US",
            "telephone_number": "423-224-1300",
            "fax_number": "423-224-1375",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CHILDRESS",
        "first_name": "TRACI",
        "middle_name": "L",
        "credential": "APRN, PMHNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-06-12",
        "last_updated": "2025-11-04",
        "certification_date": "2025-11-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "TN",
            "license": "36836",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Donna Cherry
• Lillian Rosemyra Chicco, MS, RDN, LDN
• Sally Elizabeth Chikomb
• Jessica Lynn Childers, PT
• Stephanie M Childress, FNP-C
• Susan Pope Chinouth, OTR/L
• Michelle Ann Chipponeri
• Chiro-Health, L.L.C.
• Choice Counseling, LLC
• Karen Choquette, DPH

• Psychiatric/Mental Health Nurse Practitioner in Johnson City, TN
• Providers in Johnson City, TN by specialty
• Psychiatric/Mental Health Nurse Practitioner in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 4, 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.
• 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.