Tracy Pulliam, M.D.

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

26489 Issued in AL

Practice address

1 Hospital Drive SE
Crestwood Hospital
Huntsville, AL 35801

Phone

(256) 429-5196

Fax

(256) 429-4573

NPI assigned

Mar 2, 2007

Last updated

Nov 23, 2010By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 5

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: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

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.

• Physynergy, LLC

  • Anesthesiology Physician
  • Huntsville, AL
  • NPI 1134465560
  Medicare reassignment NPD
• Inpatient Medical Consultants of North Alabama, PC

  • Hospitalist Physician
  • Huntsville, AL
  • NPI 1891934642
  Authorized official Same address or phone
• Physynergy, LLC

  • Anesthesiology Physician
  • Mobile, AL
  • NPI 1093173502
  NPD
• 4MD2 in Patient Physician Services of Decatur LLC

  • Contractor
  • Decatur, AL
  • NPI 1134273345
  NPD (past)
• Apogee Medical Group Alabama Inc

  • Internal Medicine Physician
  • Sheffield, AL
  • NPI 1114974631
  NPD (past)
• Cogent Healthcare of Decatur, LLC

  • Critical Care Medicine (Internal Medicine) Physician
  • Tuscaloosa, AL
  • NPI 1386695500
  NPD (past)
• Jackson Clinic PA

  dba Jackson Clinc PA DME

  • Durable Medical Equipment & Medical Supplies
  • Jackson, TN
  • NPI 1689443038
  NPD (past)

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

{
    "created_epoch": "1172793600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1290470400000",
    "number": "1518095124",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1814",
            "city": "MADISON",
            "state": "AL",
            "postal_code": "357585410",
            "telephone_number": "256-429-5196",
            "fax_number": "256-429-4573"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 HOSPITAL DRIVE SE",
            "address_2": "CRESTWOOD HOSPITAL",
            "city": "HUNTSVILLE",
            "state": "AL",
            "postal_code": "35801",
            "telephone_number": "256-429-5196",
            "fax_number": "256-429-4573"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PULLIAM",
        "first_name": "TRACY",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-03-02",
        "last_updated": "2010-11-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "AL",
            "license": "26489",
            "primary": true
        },
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": "AL",
            "license": "26489",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "109222",
            "state": "AL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS OF ALABAMA",
            "identifier": "515-97252",
            "state": "AL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE",
            "identifier": "510I110424",
            "state": "AL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS OF ALABAMA",
            "identifier": "51539247",
            "state": "AL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "051558692",
            "state": "AL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Vytautas Pukis, M.D.
• Pullen, DMD, P.C.
• Mark E Pullen, DMD
• Mark Edward Pullen Jr., DMD
• Jerri Ann Pulley, PHARMD
• Madelyn Anne Pullum, ALC
• Pulmonary and Sleep Associates
• Anna Pung, OTR
• Samanger Nicole Purcell-Matthew, M.D.
• Christy M Putman, CRNA

• Internal Medicine Physician in Huntsville, AL
• Providers in Huntsville, AL by specialty
• Internal Medicine Physician in Alabama

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 23, 2010; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.