Tracie Lane Gilliland, MSN, APRN, FNP-BC

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

124431 Issued in AR

Practice address

360 MC 7097
Flippin, AR 72634-8419

Phone

(870) 404-2347

NPI assigned

Apr 24, 2020

Last updated

Apr 24, 2020By 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 AR

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, 2019

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Hospital & facility affiliations

• Baxter Health Hospital, Mountain Home, AR, CCN 040027

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Science - Nursing, Nurse Practitioner

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.

• Advanced Medicine of the Ozarks, LTD

  • Family Nurse Practitioner
  • Mountain Home, AR
  • NPI 1225786916
  Medicare reassignment NPD Authorized official
• Baxter County Regional Hospital, Inc

  dba Baxter Health College Street Family Clinic

  • Family Medicine Physician
  • Mountain Home, AR
  • NPI 1316777329
  NPD
• Baxter County Regional Hospital, Inc.

  dba Baxter Health Family Clinic

  • Family Medicine Physician
  • Mountain Home, AR
  • NPI 1851725139
  NPD
• Ozarks Medical Center

  dba Ozarks Healthcare

  • General Acute Care Hospital
  • West Plains, MO
  • NPI 1831115641
  NPD (past)

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

• Baxter County Regional Hospital Inc

  dba BRMC Professional Fees

  • General Acute Care Hospital
  • Mountain Home, AR
  • NPI 1033147921
  Care Compare affiliation
• Baxter County Regional Hospital, Inc

  dba Baxter Health

  • General Acute Care Hospital
  • Mountain Home, AR
  • NPI 1881788933
  Care Compare affiliation

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

{
    "created_epoch": "1587686400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1587686400000",
    "number": "1568082006",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "360 MC 7097",
            "city": "FLIPPIN",
            "state": "AR",
            "postal_code": "726348419",
            "telephone_number": "870-404-2347"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "360 MC 7097",
            "city": "FLIPPIN",
            "state": "AR",
            "postal_code": "726348419",
            "telephone_number": "870-404-2347"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GILLILAND",
        "first_name": "TRACIE",
        "middle_name": "LANE",
        "name_prefix": "Mrs.",
        "credential": "MSN, APRN, FNP-BC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-04-24",
        "last_updated": "2020-04-24",
        "certification_date": "2020-04-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "AR",
            "license": "124431",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• FPNC, Inc. (Twin Lakes Therapy and Living)
• David Glenn Fulghum, FNP-BC
• Full Circle Recovery Incorporated
• Hannah Gallegos
• Lisa M Gardner, PHARMD
• GMT and P Enterprises (Flippin Pharmacy)
• Kim Harrison, PD
• Sylvia Irene Hathaway, FNP-BC
• Julie M King, APRN
• Johnny Mitchell

• Family Nurse Practitioner in Flippin, AR
• Providers in Flippin, AR by specialty
• Family Nurse Practitioner in Arkansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 24, 2020; 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.