Individual provider Active NPI

Tracie Thornton, CRNP

  • Nurse Practitioner
  • Huntsville, AL
National Provider Identifier
1467962472
Registry record updated Jan 18, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
1-067264 Issued in AL
Practice address
201 Sivley Road SW
Suite 200
Huntsville, AL 35801
Phone
(256) 265-1835
Fax
(256) 265-0475
NPI assigned
Oct 4, 2017
Last updated
Jan 18, 2021By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 18, 2021

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 1-067264 AL Primary

Addresses

Primary practice location

201 Sivley Road SW
Suite 200
Huntsville, AL 35801

Mailing address

201 Sivley Road SW
Suite 200
Huntsville, AL 35801
Phone (256) 265-1835

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AL
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
I20221215002368 AL Practitioner - Nurse Practitioner 2769851641 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
Alabama Cancer Care, LLCGroup PAC ID 1456477645, 20 clinicians

Practice addresses (Care Compare)

1608 Glenn Blvd SW
Fort Payne, AL 35968-3522
Phone (256) 547-0536

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
94.01 of 100Reported as group
Quality
78.97
Promoting interoperability
100
Improvement activities
40
Cost
85.77

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
1-067264ALMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Alabama Cancer Care, LLC CurrentSince Dec 7, 2022 Accepting new patients
Southeast Physician Network, P.C. Past Accepting new patients

Locations

1608 Glenn Blvd SW
Fort Payne, AL 35968
Phone (256) 244-4150

Interoperability endpoints

  • Direct secure messaging: tracie.thornton@tcchsv.ikm.direct-ci.com

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 3

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": "1507075200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1610928000000",
    "number": "1467962472",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "201 SIVLEY ROAD SW",
            "address_2": "SUITE 200",
            "city": "HUNTSVILLE",
            "state": "AL",
            "postal_code": "35801",
            "telephone_number": "256-265-1835",
            "fax_number": "256-265-0475"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "201 SIVLEY ROAD SW",
            "address_2": "SUITE 200",
            "city": "HUNTSVILLE",
            "state": "AL",
            "postal_code": "35801",
            "telephone_number": "256-265-1835",
            "fax_number": "256-265-0475"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "THORNTON",
        "first_name": "TRACIE",
        "credential": "CRNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-10-04",
        "last_updated": "2021-01-18",
        "certification_date": "2021-01-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "AL",
            "license": "1-067264",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Huntsville, AL

Sources for this page

Verify at the official NPI Registry.