Individual provider Active NPI

Tracy Fluty, FNP

  • Family Nurse Practitioner
  • Springfield, TN
National Provider Identifier
1578826111
Registry record updated Jun 19, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
APN0000016581 Issued in TN
Practice address
2308D Memorial Blvd
Springfield, TN 37172-3929
Phone
(615) 382-8144
Fax
(615) 382-8145
NPI assigned
Jun 19, 2012
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 19, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X APN0000016581 TN Primary

Addresses

Primary practice location

2308D Memorial Blvd
Springfield, TN 37172-3929

Mailing address

2308D Memorial Blvd
Springfield, TN 37172-3929
Phone (615) 382-8144

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TN, TX2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20120724001001 TN Practitioner - Nurse Practitioner 9133385818
I20141212000450 TX Practitioner - Nurse Practitioner 9133385818 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
APN0000016581TNMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Pine Ridge Indian Health Service Hospital Current Accepting new patients
Pine Ridge Indian Health Service Hospital CurrentSince Nov 17, 2014 Accepting new patients
Pine Ridge Indian Health Service Hospital CurrentSince Nov 17, 2014 Accepting new patients
Jackson and Moor, LLC CurrentSince Oct 5, 2012 Accepting new patients

Locations

5055 Maryland Way
Brentwood, TN 37027
Phone (615) 382-8144

2308D Memorial Blvd
Springfield, TN 37172
Phone (615) 382-8144

Interoperability endpoints

  • Direct secure messaging: tracy.fluty@488678167609348.direct.elationemr.com

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1340064000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1340064000000",
    "number": "1578826111",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2308D MEMORIAL BLVD",
            "city": "SPRINGFIELD",
            "state": "TN",
            "postal_code": "371723929",
            "telephone_number": "615-382-8144",
            "fax_number": "615-382-8145"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2308D MEMORIAL BLVD",
            "city": "SPRINGFIELD",
            "state": "TN",
            "postal_code": "371723929",
            "telephone_number": "615-382-8144",
            "fax_number": "615-382-8145"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FLUTY",
        "first_name": "TRACY",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-06-19",
        "last_updated": "2012-06-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TN",
            "license": "APN0000016581",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Springfield, TN

Sources for this page

Verify at the official NPI Registry.