Individual provider Active NPI

Tracy Lynn Rock, ACNP-BC

  • Acute Care Nurse Practitioner
  • Youngstown, OH
National Provider Identifier
1477810588
Registry record updated Feb 25, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Acute Care Nurse PractitionerTaxonomy code 363LA2100X
License
COA.12546-NP Issued in OH
Practice address
1001 Covington St
Youngstown, OH 44510-1617
Phone
(330) 480-2371
Fax
(330) 480-3970
NPI assigned
Apr 13, 2012
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 25, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Acute Care Nurse Practitioner 363LA2100X COA.12546-NP OH Primary

Addresses

Primary practice location

1001 Covington St
Youngstown, OH 44510-1617

Mailing address

1001 Covington St
Youngstown, OH 44510-1617
Phone (330) 480-2371

Other identifiers 2

IdentifierTypeStateIssuer
H147921OtherOHMEDICARE PTAN
0070452MedicaidOH

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH
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
I20120801000234 OH Practitioner - Nurse Practitioner 5799941068 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Mercy Health Physicians Youngstown Specialty Care LLCGroup PAC ID 3476950296, 463 clinicians

Practice addresses (Care Compare)

1001 Covington St
Youngstown, OH 44510-1617
Phone (330) 480-3195

1044 Belmont Ave
Youngstown, OH 44504-1006

410 W 10TH Ave
Columbus, OH 43210-1240
Phone (614) 293-8000

Hospital & facility affiliations

  • MH St Elizabeth Youngstown Hospital Hospital, Youngstown, OH, CCN 360064

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
COA.12546-NPOHMDAcute Care Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Mercy Health Physicians Youngstown Specialty Care LLC CurrentSince Jan 1, 2022 Accepting new patients
Mercy Health Physicians Youngstown, LLC CurrentSince Nov 3, 2014 Accepting new patients
Mercy Health Physicians Youngstown Specialty Care LLC CurrentSince Jan 1, 2022 Accepting new patients
Mercy Health Physicians Youngstown LLC CurrentSince Nov 3, 2014 Accepting new patients

Locations

410 W 10th Ave
Columbus, OH 43210
Phone (614) 293-5905

1044 Belmont Ave
Youngstown, OH 44504
Phone (330) 480-2182

1001 Covington St
Youngstown, OH 44510
Phone (330) 480-2616

250 E Federal St
Fl 4
Youngstown, OH 44503
Phone (330) 884-7010

Interoperability endpoints

  • Direct secure messaging: trock131707@direct.bsmhealth.org

Organizations & group practices 4

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.

Hospital & facility affiliations 2

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": "1334275200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1582588800000",
    "number": "1477810588",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1001 COVINGTON ST",
            "city": "YOUNGSTOWN",
            "state": "OH",
            "postal_code": "445101617",
            "telephone_number": "330-480-2371",
            "fax_number": "330-480-3970"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1001 COVINGTON ST",
            "city": "YOUNGSTOWN",
            "state": "OH",
            "postal_code": "445101617",
            "telephone_number": "330-480-2371",
            "fax_number": "330-480-3970"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROCK",
        "first_name": "TRACY",
        "middle_name": "LYNN",
        "name_prefix": "Ms.",
        "credential": "ACNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-04-13",
        "last_updated": "2020-02-25",
        "certification_date": "2020-02-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "OH",
            "license": "COA.12546-NP",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PTAN",
            "identifier": "H147921",
            "state": "OH"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0070452",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Youngstown, OH

Sources for this page

Verify at the official NPI Registry.