Tracey Nycole Blakley, FNP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

3012958 Issued in KY

Practice address

1620 E Main St
Cumberland, KY 40823

Phone

(606) 589-6113

Fax

(606) 589-4436

NPI assigned

Feb 27, 2019

Last updated

Aug 19, 2019By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in KY

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

Specialty

Nurse Practitioner

Education

Other, 2018

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Mountain Comprehensive Health CorporationGroup PAC ID 7618875873, 82 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Harlan Arh Hospital Hospital, Harlan, KY, CCN 180050

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: tracey.blakley.p1@direct.mtncomp.nextgenshare.com

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.

• Mountain Comprehensive Health Corporation

  • Primary Care Clinic/Center
  • Whitesburg, KY
  • NPI 1417900242
  Medicare reassignment Care Compare group NPD
• Mountain Comprehensive Health Corporation

  dba Mountain Comprehensive Specialty Services

  • Pulmonary Disease Physician
  • Whitesburg, KY
  • NPI 1033166350
  NPD
• Mountain Comprehensive Health Corporation

  dba Elkhorn City Optometry Clinic

  • Primary Care Clinic/Center
  • Elkhorn City, KY
  • NPI 1215818414
  NPD
• Mountain Comprehensive Health Corporation

  dba Harlan Medical Center

  • Primary Care Clinic/Center
  • Harlan, KY
  • NPI 1316991979

  Family

  NPD
• Mountain Comprehensive Health Corporation

  • Primary Care Clinic/Center
  • Cornettsville, KY
  • NPI 1326092990

  Family

  NPD
• Mountain Comprehensive Health Corporation

  • Primary Care Clinic/Center
  • Cumberland, KY
  • NPI 1992251185

  Family

  NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Appalachian Regional Healthcare, Inc.

  • General Acute Care Hospital
  • Harlan, KY
  • NPI 1306842521
  Care Compare affiliation

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

{
    "created_epoch": "1551225600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1566172800000",
    "number": "1497212302",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 40",
            "city": "WHITESBURG",
            "state": "KY",
            "postal_code": "418580040",
            "telephone_number": "606-633-4823"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1620 E MAIN ST",
            "city": "CUMBERLAND",
            "state": "KY",
            "postal_code": "40823",
            "telephone_number": "606-589-6113",
            "fax_number": "606-589-4436"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "28 Ellis road",
            "address_purpose": "LOCATION",
            "city": "Cumberland",
            "state": "KY",
            "postal_code": "40823",
            "country_code": "US",
            "telephone_number": "606-273-1234",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BLAKLEY",
        "first_name": "TRACEY",
        "middle_name": "NYCOLE",
        "credential": "FNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-02-27",
        "last_updated": "2019-08-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "KY",
            "license": "3012958",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Christa Leigh Addington, APRN
• Appalachian Regional Healthcare, Inc (ARH Tri City Medical Center)
• Appalachian Regional Healthcare, Inc (ARH Tri-Cities Clinic Pharmacy)
• Appalachian Regional Healthcare, Inc. (ARH Tri City Medical Center)
• David Scott Berman, PHARMD
• Brittany Julene Boggs
• Melissa C Burns, APRN
• Allison Eulene Caudill, PTA
• John Chaney, R.PH. P.I.C.
• Destiny Clark, PHARMD

• Family Nurse Practitioner in Cumberland, KY
• Providers in Cumberland, KY by specialty
• Family Nurse Practitioner in Kentucky

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 19, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.