Individual provider Active NPI

Tracy Nix

  • Family Nurse Practitioner
  • Hobart, IN
National Provider Identifier
1417491093
Registry record updated Feb 2, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
71006504A; 71006504B Issued in IN
Practice address
4410 W 49TH Ave
Hobart, IN 46342-3744
Phone
(855) 611-8783
NPI assigned
Dec 15, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 2, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 71006504A; 71006504B IN Primary

Addresses

Primary practice location

4410 W 49TH Ave
Hobart, IN 46342-3744

Mailing address

415 W Golf Rd Ste 26
Arlington Heights, IL 60005-3923
Phone (855) 700-8184

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IN
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

Enrollment IDStateProvider typePAC IDDetails
I20170127000520 IN Practitioner - Nurse Practitioner 4880976869 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Comprehensive Rehab Consultants PLLCGroup PAC ID 6800220682, 251 clinicians

Practice addresses (Care Compare)

221 W Division St
Demotte, IN 46310-8377
Phone (219) 987-7005

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
71006504A; 71006504BINMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Comprehensive Rehab Consultants PLLC Family CurrentSince Mar 17, 2020 Accepting new patients
NP Health of Mo LLC Past Accepting new patients

Locations

415 W Golf Rd
Ste 26
Arlington Hts, IL 60005

780 Dickinson Rd
Chesterton, IN 46304
Phone (219) 785-8424

4111 Park Place Dr
Fort Wayne, IN 46845
Phone (260) 373-2111

2901 W 37th Ave
Hobart, IN 46342
Phone (219) 942-2170

4410 W 49th Ave
Hobart, IN 46342
Phone (219) 942-3279

3530 Monroe St
Laporte, IN 46350
Phone (219) 785-8424

5909 Lute Rd
Portage, IN 46368
Phone (219) 462-4411

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1481760000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1675296000000",
    "number": "1417491093",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "415 W GOLF RD STE 26",
            "city": "ARLINGTON HEIGHTS",
            "state": "IL",
            "postal_code": "600053923",
            "telephone_number": "855-700-8184"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4410 W 49TH AVE",
            "city": "HOBART",
            "state": "IN",
            "postal_code": "463423744",
            "telephone_number": "855-611-8783"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NIX",
        "first_name": "TRACY",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-12-15",
        "last_updated": "2023-02-02",
        "certification_date": "2023-02-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "IN",
            "license": "71006504A; 71006504B",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hobart, IN

Sources for this page

Verify at the official NPI Registry.