Active NPI
Traci I Emerson, AGACNP-BC
- Acute Care Nurse Practitioner
- Evansville, IN
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Acute Care Nurse Practitioner
- License
- 71007727A
- Practice address
- 3700 Washington Ave
Evansville, IN 47714-0541 - Phone
- (812) 485-4000
- NPI assigned
- Nov 14, 2017
- 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 |
|---|---|---|---|---|
| Gerontology Nurse Practitioner | 363LG0600X | 71007727A | IN | |
| Acute Care Nurse Practitioner | 363LA2100X | 71007727A | IN | Primary |
| Adult Health Nurse Practitioner | 363LA2200X | 71007727A | IN |
Addresses
Primary practice location
3700 Washington Ave
Evansville, IN 47714-0541
Mailing address
10330 N Meridian St # 300
Indianapolis, IN 46290-1024
Other practice location 1
3700 Washington Ave
Evansville, IN 47714-0541
Phone (812) 485-4000
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in IN
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: No
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20180214000457 | IN | Practitioner - Nurse Practitioner | 0749540672 | Reassigns benefits to 1 organization |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 71007727A | IN | MD | Adult Health Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| St Mary'S Medical Group, LLC | Acute Care | Current | Accepting new patients |
| St Mary'S Medical Group, LLC | Current | Accepting new patients |
Locations
1116 Millis Ave
Boonville, IN 47601
Phone (812) 897-4800
801 Saint Marys Dr
Ste 505E
Evansville, IN 47714
Phone (812) 491-3236
3700 Washington Ave
Evansville, IN 47714
Phone (812) 232-0021
3801 Bellemeade Ave
Ste 110
Evansville, IN 47714
Phone (812) 471-1200
Organizations & group practices 2
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.
-
- Nephrology Physician
- Evansville, IN
- NPI 1619307873
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1510617600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1517270400000",
"number": "1578076337",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "10330 N MERIDIAN ST # 300",
"city": "INDIANAPOLIS",
"state": "IN",
"postal_code": "462901024"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3700 WASHINGTON AVE",
"city": "EVANSVILLE",
"state": "IN",
"postal_code": "477140541",
"telephone_number": "812-485-4000"
}
],
"practiceLocations": [
{
"address_1": "3700 Washington Ave",
"address_purpose": "LOCATION",
"city": "Evansville",
"state": "IN",
"postal_code": "477140541",
"country_code": "US",
"telephone_number": "812-485-4000",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "EMERSON",
"first_name": "TRACI",
"middle_name": "I",
"credential": "AGACNP-BC",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2017-11-14",
"last_updated": "2018-01-30",
"status": "A"
},
"taxonomies": [
{
"code": "363LG0600X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Gerontology",
"state": "IN",
"license": "71007727A",
"primary": false
},
{
"code": "363LA2100X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Acute Care",
"state": "IN",
"license": "71007727A",
"primary": true
},
{
"code": "363LA2200X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Adult Health",
"state": "IN",
"license": "71007727A",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Evansville, IN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 30, 2018; 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.