Tracy Ann Pefferkorn, LPC

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

P1001005 Issued in AR

Practice address

403 Filmore St.
Fordyce, AR 71742

Phone

(870) 313-1579

Fax

(870) 352-5127

NPI assigned

Mar 6, 2007

Last updated

May 13, 2024By 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: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Mental Health Counselor

Education

Other, 2001

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Reding and Leach MD PLLCGroup PAC ID 7012258627, 62 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: tracy.pefferkorn.1@21565.direct.athenahealth.com

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.

• Reding & Leach MD PLLC

  • Psychiatry Physician
  • Little Rock, AR
  • NPI 1245723584
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1173139200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1715558400000",
    "number": "1619007226",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "403 FILMORE ST.",
            "city": "FORDYCE",
            "state": "AR",
            "postal_code": "71742",
            "telephone_number": "870-313-1579",
            "fax_number": "870-352-5127"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "403 FILMORE ST.",
            "city": "FORDYCE",
            "state": "AR",
            "postal_code": "71742",
            "telephone_number": "870-313-1579",
            "fax_number": "870-352-5127"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PEFFERKORN",
        "first_name": "TRACY",
        "middle_name": "ANN",
        "credential": "LPC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-03-06",
        "last_updated": "2024-05-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "AR",
            "license": "P1001005",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Samara Nolen, MHPP
• Alisa Kijuana Oneal, MHPP
• Kimra Lynn Osburn, MHPP
• Sondra Lynn Parker, RN
• Patrick P Moseley Family Dentistry
• Jeanna Pennington, LPC
• Debra Perry, MHPP
• Emily Phillips, QBHP
• Pine Forest Health and Rehab Center, LLC (dba Dallas County Nursing Home)
• Pioneer Health Services, Inc. (PHS of Dallas)

• Mental Health Counselor in Fordyce, AR
• Providers in Fordyce, AR by specialty
• Mental Health Counselor in Arkansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 13, 2024; 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.