Individual provider Active NPI

Tracie Katherine Mudge, APRN, BC

  • Nurse Practitioner
  • Tampa, FL
National Provider Identifier
1598740805
Registry record updated Nov 27, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
ARNP9333268 Issued in FL
Practice address
409 Bayshore Blvd
Tampa, FL 33606-2707
Phone
(813) 844-9302
Fax
(813) 844-1655
NPI assigned
Dec 8, 2005
Last updated
Nov 27, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 27, 2023

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X ARNP9333268 FL Primary
Acute Care Nurse Practitioner 363LA2100X R55588 NM
Acute Care Nurse Practitioner 363LA2100X ARNP9333268 FL

Addresses

Primary practice location

409 Bayshore Blvd
Tampa, FL 33606-2707

Mailing address

PO Box 917770
Orlando, FL 32891-0001

Other practice location 1

2 Tampa General Cir
Tampa, FL 33606-3571
Phone (813) 821-8038

Electronic endpoints 2

TypeEndpointUseAffiliation
Direct Messaging Address tmudge53533@direct.tgh.org
Direct Messaging Address tmudge53533@direct.tgh.org

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
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

Enrollment IDStateProvider typePAC IDDetails
I20120529000200 FL Practitioner - Nurse Practitioner 6103835749 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

4202 E Fowler Ave
Tampa, FL 33620-6750

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Tampa General Medical Group Inc Current Accepting new patients
Tampa General Hospital Current Accepting new patients
Tampa General Medical Group Inc CurrentSince Apr 1, 2016 Accepting new patients
University Medical Service Association Inc CurrentSince Sep 8, 2023 Accepting new patients
University Medical Service Association Inc CurrentSince Sep 8, 2023 Accepting new patients
Tampa General Medical Group Inc CurrentSince Apr 1, 2016 Accepting new patients
University Medical Service Association Inc Current Accepting new patients
University Medical Service Association Inc Past Accepting new patients

Locations

214 Morrison Rd
Ste 110
Brandon, FL 33511
Phone (800) 844-9302

2 Tampa General Cir
Tampa, FL 33606
Phone (813) 259-0929

409 Bayshore Blvd
Tampa, FL 33606
Phone (813) 253-2640

4202 E Fowler Ave
Stop SHS100
Tampa, FL 33620
Phone (813) 974-2331

5 Tampa General Cir
Tampa, FL 33606
Phone (813) 251-0793

5802 N 30th St
Tampa, FL 33610
Phone (813) 236-5100

2433 Country Place Blvd
Trinity, FL 34655
Phone (813) 844-8200

Networks

  • Optimum HealthCare HMO Network
  • Freedom Health HMO Network

Interoperability endpoints

  • FHIR API: https://epicproxy.et0761.epichosted.com/FHIRProxy/api/FHIR/R4/
  • Direct secure messaging: tmudge53533@direct.tgh.org

Organizations & group practices 8

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.

Hospital & facility affiliations 1

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

NPI Registry JSON

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

{
    "created_epoch": "1134000000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1701043200000",
    "number": "1598740805",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 917770",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328910001"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "409 BAYSHORE BLVD",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336062707",
            "telephone_number": "813-844-9302",
            "fax_number": "813-844-1655"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2 Tampa General Cir",
            "address_purpose": "LOCATION",
            "city": "Tampa",
            "state": "FL",
            "postal_code": "336063571",
            "country_code": "US",
            "telephone_number": "813-821-8038",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MUDGE",
        "first_name": "TRACIE",
        "middle_name": "KATHERINE",
        "name_prefix": "Ms.",
        "credential": "APRN, BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-12-08",
        "last_updated": "2023-11-27",
        "certification_date": "2023-11-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "FL",
            "license": "ARNP9333268",
            "primary": true
        },
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "NM",
            "license": "R55588",
            "primary": false
        },
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "FL",
            "license": "ARNP9333268",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "tmudge53533@direct.tgh.org",
            "affiliation": "N",
            "address_1": "409 Bayshore Blvd",
            "city": "Tampa",
            "state": "FL",
            "country_code": "US",
            "postal_code": "336062707",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "tmudge53533@direct.tgh.org",
            "affiliation": "N",
            "address_1": "2 Tampa General Cir",
            "city": "Tampa",
            "state": "FL",
            "country_code": "US",
            "postal_code": "336063571",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Tampa, FL

Sources for this page

Verify at the official NPI Registry.