Active NPI
Tracy Louise Stephens, NP
- Nurse Practitioner
- Fort Thomas, KY
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Nurse Practitioner
- License
- 3007746
- Practice address
- 85 N Grand Ave
Fort Thomas, KY 41075-1793 - Phone
- (859) 912-7211
- Fax
- (859) 655-6674
- NPI assigned
- Jun 5, 2007
- 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 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Adult Health Nurse Practitioner | 363LA2200X | 291717 | OH | |
| Nurse Practitioner | 363L00000X | 71004389A | IN | |
| Nurse Practitioner | 363L00000X | 3007746 | KY | Primary |
Addresses
Primary practice location
85 N Grand Ave
Fort Thomas, KY 41075-1793
Mailing address
PO Box 635283
Cincinnati, OH 45263-5483
Phone (859) 344-5555
Other identifiers 3
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 201152200 | Medicaid | IN | |
| 3031623 | Medicaid | OH | |
| 7100233730 | Medicaid | KY |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in KY
- 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, 2006
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
1500 James Simpson Jr Way
Covington, KY 41011-0800
Phone (859) 655-4111
Merit-based Incentive Payment System (MIPS)
- Final score
- 93.01 of 100
- Quality
- 86.02
- Promoting interoperability
- 100
- Improvement activities
- 40
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- HHS exclusion list flag
- Flagged The directory lists this NPI on an HHS exclusion list.
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 291717 | OH | MD | Adult Health Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Summit Medical Group, Inc | Nurse Practitioner | Current | Accepting new patients |
| Summit Medical Group, Inc. | Current | Accepting new patients | |
| Hospice of Southwest Ohio, Inc. | Past | Accepting new patients |
Locations
1500 James Simpson Jr Way
Covington, KY 41011
Phone (859) 655-4353
85 N Grand Ave
Fort Thomas, KY 41075
Phone (859) 572-3100
1980 Litton Ln
Hebron, KY 41048
Phone (859) 334-8700
238 Barnes Rd
Williamstown, KY 41097
Phone (859) 292-4000
300 Barnes Rd
Williamstown, KY 41097
Phone (859) 824-8217
Interoperability endpoints
- tstephens180098@direct-prd.stelizabeth.com
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 and National Provider Directory roles.
-
- Foot & Ankle Surgery Podiatrist
- Crestview Hills, KY
- NPI 1043188378
-
- Community Based Hospice Care Agency
- Cincinnati, OH
- NPI 1043295611
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1181001600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1614902400000",
"number": "1568664142",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 635283",
"city": "CINCINNATI",
"state": "OH",
"postal_code": "452635483",
"telephone_number": "859-344-5555",
"fax_number": "859-344-5552"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "85 N GRAND AVE",
"city": "FORT THOMAS",
"state": "KY",
"postal_code": "410751793",
"telephone_number": "859-912-7211",
"fax_number": "859-655-6674"
}
],
"practiceLocations": [],
"basic": {
"last_name": "STEPHENS",
"first_name": "TRACY",
"middle_name": "LOUISE",
"credential": "NP",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-06-05",
"last_updated": "2021-03-05",
"certification_date": "2021-03-05",
"status": "A"
},
"taxonomies": [
{
"code": "363LA2200X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Adult Health",
"state": "OH",
"license": "291717",
"primary": false
},
{
"code": "363L00000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner",
"state": "IN",
"license": "71004389A",
"primary": false
},
{
"code": "363L00000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner",
"state": "KY",
"license": "3007746",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "201152200",
"state": "IN"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "3031623",
"state": "OH"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "7100233730",
"state": "KY"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Fort Thomas, KY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 5, 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.