Active NPI
Luann Marie Tracey, FNP
- Family Nurse Practitioner
- Niles, MI
National Provider Identifier
1528358405
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Nurse Practitioner
- License
- 4704199458
- Practice address
- 1951 Oak St
Niles, MI 49120-3738 - Phone
- (269) 262-4749
- Fax
- (269) 262-4739
- NPI assigned
- Apr 13, 2011
- Last updated
- Oct 2, 2026
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Nurse Practitioner | 363LF0000X | 4704199458 | MI | Primary |
Addresses
Primary practice location
1951 Oak St
Niles, MI 49120-3738
Mailing address
1951 Oak St
Niles, MI 49120-3738
Phone (269) 262-4749
Other identifiers 4
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 000000789433 | Other | IN | ANTHEM |
| 000000714843 | Other | IN | ANTHEM |
| 000000714838 | Other | IN | ANTHEM |
| 201024030 | Medicaid | IN |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in MI
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: No
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Nurse Practitioner
- Education
- Other, 2010
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
261 M
Suite 62
Cassopolis, MI 49031-1034
Phone (269) 445-3874
Hospital & facility affiliations
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 71003603A | IN | MD | Family Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Lakeland Immediate Care Center | Current | Accepting new patients | |
| Lakeland Immediate Care Center | Current | Accepting new patients | |
| Lakeland Immediate Care Center | Past | Accepting new patients |
Locations
261 M 62
Cassopolis, MI 49031
Phone (269) 445-3874
1951 Oak St
Niles, MI 49120
Phone (269) 262-4749
Interoperability endpoints
- ltracey246417@epic00.shdirect.org
- ltracey33830@lakeland.midirect.net
Organizations & group practices 3
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.
-
dba Cassopolis Family Clinic
- Federally Qualified Health Center (FQHC)
- Cassopolis, MI
- NPI 1982677548
-
dba Cass Family Clinic-Dowagiac
- Federally Qualified Health Center (FQHC)
- Dowagiac, MI
- NPI 1881492338
-
dba Niles Community Health Center
- Federally Qualified Health Center (FQHC)
- Niles, MI
- NPI 1760802912
Hospital & facility affiliations 3
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
dba Corewell Health Lakeland Hospitals
- General Acute Care Hospital
- Saint Joseph, MI
- NPI 1134220031
-
dba Corewell Health Lakeland Hospitals St. Joseph Hospital
- Home Health Agency
- Benton Harbor, MI
- NPI 1912094525
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1302652800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1790899200000",
"number": "1528358405",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1951 OAK ST",
"city": "NILES",
"state": "MI",
"postal_code": "491203738",
"telephone_number": "269-262-4749",
"fax_number": "269-262-4739"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1951 OAK ST",
"city": "NILES",
"state": "MI",
"postal_code": "491203738",
"telephone_number": "269-262-4749",
"fax_number": "269-262-4739"
}
],
"practiceLocations": [],
"basic": {
"last_name": "TRACEY",
"first_name": "LUANN",
"middle_name": "MARIE",
"credential": "FNP",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2011-04-13",
"last_updated": "2026-10-02",
"certification_date": "2026-10-02",
"status": "A"
},
"taxonomies": [
{
"code": "363LF0000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Family",
"state": "MI",
"license": "4704199458",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "ANTHEM",
"identifier": "000000789433",
"state": "IN"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "ANTHEM",
"identifier": "000000714843",
"state": "IN"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "ANTHEM",
"identifier": "000000714838",
"state": "IN"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "201024030",
"state": "IN"
}
],
"endpoints": [],
"other_names": []
}Other providers in Niles, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 2, 2026; 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.