NPIMap

Individual provider Active NPI

Tracy Lynn Davis, MD PHD

  • Dermatopathology (Pathology) Physician
  • Tucson, AZ
National Provider Identifier
1447287362
Registry record updated Aug 10, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dermatopathology (Pathology) PhysicianTaxonomy code 207ZD0900X
License
41612 Issued in AZ
Practice address
2495 N Desert Links Dr Apt 85
Tucson, AZ 85715-3736
Phone
(602) 320-6105
NPI assigned
Jun 27, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 10, 2015

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Anatomic Pathology Physician 207ZP0101X 41612 AZ
Dermatopathology (Pathology) Physician 207ZD0900X 41612 AZ Primary
Anatomic Pathology Physician 207ZP0101X A99627 CA
Dermatopathology (Pathology) Physician 207ZD0900X A99627 CA

Addresses

Primary practice location

2495 N Desert Links Dr Apt 85
Tucson, AZ 85715-3736

Mailing address

2495 N Desert Links Dr Apt 85
Tucson, AZ 85715-3736
Phone (602) 320-6105

Other identifiers 1

IdentifierTypeStateIssuer
429834MedicaidAZ

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine, Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
41612AZMDAnatomic Pathology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Diagnostic Pathology Medical Group Inc Past Accepting new patients
Diagnostic Pathology Medical Group, Inc. Anatomic Pathology & Clinical Pathology Past Accepting new patients

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": "1151366400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1439164800000",
    "number": "1447287362",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2495 N DESERT LINKS DR APT 85",
            "city": "TUCSON",
            "state": "AZ",
            "postal_code": "857153736",
            "telephone_number": "602-320-6105"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2495 N DESERT LINKS DR APT 85",
            "city": "TUCSON",
            "state": "AZ",
            "postal_code": "857153736",
            "telephone_number": "602-320-6105"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAVIS",
        "first_name": "TRACY",
        "middle_name": "LYNN",
        "name_prefix": "Dr.",
        "credential": "MD PHD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-06-27",
        "last_updated": "2015-08-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207ZP0101X",
            "taxonomy_group": "",
            "desc": "Pathology, Anatomic Pathology",
            "state": "AZ",
            "license": "41612",
            "primary": false
        },
        {
            "code": "207ZD0900X",
            "taxonomy_group": "",
            "desc": "Pathology, Dermatopathology",
            "state": "AZ",
            "license": "41612",
            "primary": true
        },
        {
            "code": "207ZP0101X",
            "taxonomy_group": "",
            "desc": "Pathology, Anatomic Pathology",
            "state": "CA",
            "license": "A99627",
            "primary": false
        },
        {
            "code": "207ZD0900X",
            "taxonomy_group": "",
            "desc": "Pathology, Dermatopathology",
            "state": "CA",
            "license": "A99627",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "429834",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Tucson, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 10, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.