NPIMap

Individual provider Active NPI

Tracy King Fasolino, NP

  • Nurse Practitioner
  • Greenville, SC
National Provider Identifier
1427006170
Registry record updated Sep 24, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
F1070 Issued in SC
Practice address
317 Saint Francis Dr
Greenville, SC 29601-3965
Phone
(864) 255-1304
NPI assigned
May 5, 2006
Last updated
Sep 24, 2014By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 24, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X F1070 SC Primary

Addresses

Primary practice location

317 Saint Francis Dr
Greenville, SC 29601-3965

Mailing address

PO Box 25039
Greenville, SC 29616-0039
Phone (864) 605-3720

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in SC
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
I20040804001266 SC Practitioner - Nurse Practitioner 9133190911 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

3 Saint Francis Dr
Greenville, SC 29601-3972

317 Saint Francis Dr
Suite 220
Greenville, SC 29601-3976
Phone (864) 255-1901

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
F1070SCMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Bon Secours Ambulatory Services - St. Francis, LLC CurrentSince Mar 20, 2020 Accepting new patients
St Francis Physician Services Inc CurrentSince May 1, 2011 Accepting new patients
Woodruff Road Urgent Care Center, P.C. Current Accepting new patients
Bon Secours Medical Group Greenville Specialty Care LLC CurrentSince May 21, 2022 Accepting new patients
Bon Secours Medical Group Greenville Specialty Care LLC CurrentSince May 21, 2022 Accepting new patients
St Francis Physician Services Inc CurrentSince May 1, 2011 Accepting new patients
Acs Emergency Physicians of SC PC Nurse Practitioner Past Accepting new patients
St Francis Physician Services Inc Past Accepting new patients
United Emergency Services, Inc. Nurse Practitioner Past Accepting new patients
Southeastern Emergency Services P C Nurse Practitioner Past Accepting new patients

Locations

1 Saint Francis Dr
Greenville, SC 29601
Phone (864) 225-1000

1200 Brookfield Blvd
Ste 400B
Greenville, SC 29607
Phone (864) 605-3721

1467 Woodruff Rd
Ste C
Greenville, SC 29607
Phone (864) 458-8126

3 Saint Francis Dr
Ste 300
Greenville, SC 29601
Phone (864) 233-8063

317 Saint Francis Dr
Greenville, SC 29601
Phone (803) 987-7000

317 Saint Francis Dr
Ste 220
Greenville, SC 29601
Phone (864) 255-1901

8580 Magellan Pkwy
Richmond, VA 23227
Phone (804) 627-5462

Interoperability endpoints

  • Direct secure messaging: tfasolino1151039@direct.bsmhealth.org
  • Direct secure messaging: tfasolino363313@direct.musc.edu

Organizations & group practices 10

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.

Hospital & facility affiliations 6

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": "1146787200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1411516800000",
    "number": "1427006170",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 25039",
            "city": "GREENVILLE",
            "state": "SC",
            "postal_code": "296160039",
            "telephone_number": "864-605-3720"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "317 SAINT FRANCIS DR",
            "city": "GREENVILLE",
            "state": "SC",
            "postal_code": "296013965",
            "telephone_number": "864-255-1304"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FASOLINO",
        "first_name": "TRACY",
        "middle_name": "KING",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-05-05",
        "last_updated": "2014-09-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "SC",
            "license": "F1070",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Greenville, SC

Sources for this page

Verify at the official NPI Registry.