NPIMap

Individual provider Active NPI

Tracie D. George, FNP-C

  • Family Nurse Practitioner
  • Pascagoula, MS
National Provider Identifier
1629514286
Registry record updated Nov 8, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
901889 Issued in MS
Practice address
2809 Denny Ave
Pascagoula, MS 39581-5301
Phone
(228) 809-5566
Fax
(228) 809-5414
NPI assigned
Jan 6, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 8, 2021

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 901889 MS Primary

Addresses

Primary practice location

2809 Denny Ave
Pascagoula, MS 39581-5301

Mailing address

2809 Denny Ave
Pascagoula, MS 39581-5301
Phone (228) 809-5566

Other names 1

  • Tracie D. Green Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MS, AL2 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20170313000440 MS Practitioner - Nurse Practitioner 5698059657 Reassigns benefits to 2 organizations
I20180330000659 AL Practitioner - Nurse Practitioner 5698059657 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
University of South Alabama College of Medicine, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Singing River Health SystemGroup PAC ID 3870405194, 290 clinicians

Practice addresses (Care Compare)

2809 Denny Ave
Pascagoula, MS 39581-5301
Phone (228) 818-0563

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Singing River Health System CurrentSince Nov 1, 2021 Accepting new patients
Singing River Gulfport CurrentSince Nov 1, 2021 Accepting new patients
Baldwin Emergency Physicians, P.C.. CurrentSince Feb 1, 2018 Accepting new patients
Singing River Health System Past Accepting new patients

Locations

29487 State Highway 181
Daphne, AL 36526
Phone (251) 279-5400

750 Morphy Ave
Fairhope, AL 36532
Phone (251) 928-2375

1720A Medical Park Dr
Ste 220
Biloxi, MS 39532
Phone (228) 392-9355

350 Cowan Rd
Gulfport, MS 39507
Phone (228) 206-7054

3109 Bienville Blvd
Ocean Springs, MS 39564
Phone (228) 818-1100

2525 Telephone Rd
Pascagoula, MS 39567
Phone (228) 762-4483

2809 Denny Ave
Pascagoula, MS 39581
Phone (228) 809-5000

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 and National Provider Directory roles.

Hospital & facility affiliations 63

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

View all 63

NPI Registry JSON

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

{
    "created_epoch": "1483660800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1636329600000",
    "number": "1629514286",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2809 DENNY AVE",
            "city": "PASCAGOULA",
            "state": "MS",
            "postal_code": "395815301",
            "telephone_number": "228-809-5566"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2809 DENNY AVE",
            "city": "PASCAGOULA",
            "state": "MS",
            "postal_code": "395815301",
            "telephone_number": "228-809-5566",
            "fax_number": "228-809-5414"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GEORGE",
        "first_name": "TRACIE",
        "middle_name": "D.",
        "name_prefix": "Mrs.",
        "credential": "FNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-01-06",
        "last_updated": "2021-11-08",
        "certification_date": "2021-11-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MS",
            "license": "901889",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "TRACIE",
            "last_name": "GREEN",
            "middle_name": "D.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Pascagoula, MS

Sources for this page

Verify at the official NPI Registry.