Tracy Lee Mathena, MD

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

0101240789 Issued in VA

Practice address

600 W Ridge Rd
Wythe County Community Hospital
Wytheville, VA 24382-1044

Phone

(276) 228-1775

Fax

(276) 228-1776

NPI assigned

Dec 16, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in VA

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

Emergency MedicineAlso: Family Practice, Internal Medicine

Education

Eastern Virginia Medical School, 2003

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Emergency Coverage LLCGroup PAC ID 3072412592, 761 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Wythe County Community Hospital Hospital, Wytheville, VA, CCN 490111

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

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 and National Provider Directory roles.

• Emergency Coverage, LLC

  • Family Medicine Physician
  • Newport, TN
  • NPI 1427005008

  VA

  Medicare reassignment Care Compare group NPD
• Apogee Medical Group Virginia, PC

  • Internal Medicine Physician
  • Scottsdale, AZ
  • NPI 1861660540

  VA

  Medicare reassignment NPD
• Wellmont Physician Services Inc

  • Internal Medicine Physician
  • Big Stone Gap, VA
  • NPI 1619095403

  Family Medicine

  NPD (past)
• Wythe County Physician Practices LLC

  • Diagnostic Radiology Physician
  • Wytheville, VA
  • NPI 1457168494
  NPD (past)
• Wythe County Physician Practices LLC

  • Family Medicine Physician
  • Wytheville, VA
  • NPI 1780630327
  NPD (past)
• Emergency Coverage Services, PC

  • Nurse Practitioner
  • Lawrenceburg, TN
  • NPI 1053351593
  NPD (past)
• Southeastern Physician Services PC

  • Hospitalist Physician
  • Oak Ridge, TN
  • NPI 1083835441

  Internal Medicine

  NPD (past)

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

• Wythe County Community Hospital LLC

  • Rural Acute Care Hospital
  • Wytheville, VA
  • NPI 1184706152
  Care Compare affiliation

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

{
    "created_epoch": "1166227200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1257206400000",
    "number": "1386706018",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "685 LORETTO DR",
            "city": "WYTHEVILLE",
            "state": "VA",
            "postal_code": "243822085",
            "telephone_number": "272-228-2216"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "600 W RIDGE RD",
            "address_2": "WYTHE COUNTY COMMUNITY HOSPITAL",
            "city": "WYTHEVILLE",
            "state": "VA",
            "postal_code": "243821044",
            "telephone_number": "276-228-1775",
            "fax_number": "276-228-1776"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MATHENA",
        "first_name": "TRACY",
        "middle_name": "LEE",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-12-16",
        "last_updated": "2009-11-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "VA",
            "license": "0101240789",
            "primary": true
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "VA",
            "license": "0101240789",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7100049800",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Debra Shortridge Magee, FNP
• Noah A. Malavolti, D.C.
• Goutham Mandadi, MD
• Mary Beth Marinus, CFNP
• Mark T. Larsen, LPC LLC
• Elizabeth B Matthews, LICENSED PHYSICAL TH
• Amanda McBride
• Angela Marie McCabe
• Dianne M McCarty, LCSW
• Grayson Pate McCarty, OTR/L

• Family Medicine Physician in Wytheville, VA
• Providers in Wytheville, VA by specialty
• Family Medicine Physician in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 3, 2009; 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.