Tracy Smith Mayberry, DPM

Primary specialty

PodiatristTaxonomy code 213E00000X

License

000763 Issued in GA

Practice address

1683 Washington Rd
East Point, GA 30344-4265

Phone

(404) 766-6400

Fax

(404) 766-6450

NPI assigned

Nov 23, 2005

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 6

Addresses

Other identifiers 2

Other names 1

• Dr. Tracy Aletta Smith Former name

Medicare fee-for-service enrollment

Enrolled in GA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Podiatry

Education

Kent State University College of Podiatric Medicine, 1993

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Neighbormd of Atlanta LLCGroup PAC ID 1153725668, 4 clinicians

The Southeast Permanente Medical GroupGroup PAC ID 6204829013, 823 clinicians

Practice addresses (Care Compare)

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: tracy.mayberry@nmol.eclinicaldirectplus.com

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.

• Neighbormd of Atlanta LLC

  • Internal Medicine Physician
  • Atlanta, GA
  • NPI 1902407752
  Medicare reassignment Care Compare group NPD
• The Southeast Permanente Medical Group

  • Internal Medicine Physician
  • Atlanta, GA
  • NPI 1245266956

  Podiatrist

  Medicare reassignment Care Compare group NPD
• Crosslinks Family Practice, LLC

  • Family Medicine Physician
  • Tucker, GA
  • NPI 1295131530
  NPD
• PMR Georgia Holding, LLC

  • Specialist
  • Miami Gardens, FL
  • NPI 1609329630
  NPD
• Neighbormd of South Atlanta LLC

  • Internal Medicine Physician
  • Atlanta, GA
  • NPI 1285235036
  NPD (past)

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

{
    "created_epoch": "1132704000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1612742400000",
    "number": "1497738413",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1683 WASHINGTON ROAD",
            "city": "EAST POINT",
            "state": "GA",
            "postal_code": "303444265",
            "telephone_number": "404-766-6400",
            "fax_number": "404-766-6450"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1683 WASHINGTON RD",
            "city": "EAST POINT",
            "state": "GA",
            "postal_code": "303444265",
            "telephone_number": "404-766-6400",
            "fax_number": "404-766-6450"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MAYBERRY",
        "first_name": "TRACY",
        "middle_name": "SMITH",
        "name_prefix": "Dr.",
        "credential": "DPM",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2005-11-23",
        "last_updated": "2021-02-08",
        "certification_date": "2021-02-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213EP1101X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Primary Podiatric Medicine",
            "state": "GA",
            "license": "POD000763",
            "primary": false
        },
        {
            "code": "213ER0200X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Radiology",
            "state": "GA",
            "license": "POD000763",
            "primary": false
        },
        {
            "code": "213ES0000X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Sports Medicine",
            "state": "GA",
            "license": "POD000763",
            "primary": false
        },
        {
            "code": "213ES0103X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": "GA",
            "license": "POD000763",
            "primary": false
        },
        {
            "code": "213ES0131X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Foot Surgery",
            "state": "GA",
            "license": "POD000763",
            "primary": false
        },
        {
            "code": "213E00000X",
            "taxonomy_group": "",
            "desc": "Podiatrist",
            "state": "GA",
            "license": "000763",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "480028687",
            "state": "GA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000672119F",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "TRACY",
            "last_name": "SMITH",
            "middle_name": "ALETTA",
            "prefix": "DR.",
            "credential": "DPM",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Mark Lynn OD & Associates PC
• Louis G Martin, MD
• Kristasha Martinez
• Jonathan Edward Matey, PT
• Mattress Fast LLC
• Terrilia Mays
• Regina McBride
• Ashley McCann, MD
• Kimberly McCants, LMT, CPT
• Latasha McCoy

• Podiatrist in East Point, GA
• Providers in East Point, GA by specialty
• Podiatrist in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 8, 2021; 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.