Individual provider Active NPI

Tracey Lucinda Taylor, CRNP

  • Acute Care Nurse Practitioner
  • Mobile, AL
National Provider Identifier
1518945245
Registry record updated Dec 1, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Acute Care Nurse PractitionerTaxonomy code 363LA2100X
License
1-127834 Issued in AL
Practice address
2451 Fillingim St
Mobile, AL 36617-2238
Phone
(251) 471-7000
NPI assigned
Jan 3, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 1, 2016

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Acute Care Nurse Practitioner 363LA2100X APN0000011846 TN
Acute Care Nurse Practitioner 363LA2100X 1-127834 AL Primary

Addresses

Primary practice location

2451 Fillingim St
Mobile, AL 36617-2238

Mailing address

PO Box 40010
Mobile, AL 36640-0010
Phone (251) 471-7944

Other names 1

  • Tracey L Taylor-Overholts Former name

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
I20120228000125 AL Practitioner - Nurse Practitioner 9335156009 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
APN0000011846TNMDAcute Care Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
University of South Alabama Current Accepting new patients
University of South Alabama CurrentSince Mar 1, 2018 Accepting new patients
University of South Alabama Current Accepting new patients
University of South Alabama Mitchell Cancer Institute CurrentSince Mar 1, 2018 Accepting new patients

Locations

1660 Spring Hill Ave
Mobile, AL 36604
Phone (251) 445-9616

1660 Spring Hill Ave
Ste 3069
Mobile, AL 36604
Phone (251) 445-8405

2451 University Hospital Dr
Mobile, AL 36617
Phone (251) 471-7000

2451 Fillingim St
Mobile, AL 36617
Phone (251) 434-3711

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.

NPI Registry JSON

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

{
    "created_epoch": "1136246400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1480550400000",
    "number": "1518945245",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 40010",
            "city": "MOBILE",
            "state": "AL",
            "postal_code": "366400010",
            "telephone_number": "251-471-7944",
            "fax_number": "251-471-7451"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2451 FILLINGIM ST",
            "city": "MOBILE",
            "state": "AL",
            "postal_code": "366172238",
            "telephone_number": "251-471-7000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TAYLOR",
        "first_name": "TRACEY",
        "middle_name": "LUCINDA",
        "credential": "CRNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-01-03",
        "last_updated": "2016-12-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "TN",
            "license": "APN0000011846",
            "primary": false
        },
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "AL",
            "license": "1-127834",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "TRACEY",
            "last_name": "TAYLOR-OVERHOLTS",
            "middle_name": "L",
            "credential": "CRNP",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Mobile, AL

Sources for this page

Verify at the official NPI Registry.