Tracie L Davis

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

71014807A Issued in IN

Practice address

1373 E State Road 62
Madison, IN 47250-7328

Phone

(812) 801-0152

Fax

(812) 801-0150

NPI assigned

Dec 28, 2023

Last updated

Nov 6, 2025By 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

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in KY, IN, NH3 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 3

Specialty

Nurse Practitioner

Education

Other, 2020

Medicare assignment

May accept Medicare assignment

Telehealth

Offers telehealth services

Group practices

Community Medical Associates IncGroup PAC ID 7012811284, 1,368 clinicians

Addiction Wellness Center in LLCGroup PAC ID 6608315932, 2 clinicians

Addiction Wellness Center NH LLCGroup PAC ID 0941735963, 7 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Norton-King's Daughters' Health Hospital, Madison, IN, CCN 150069

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Addiction Wellness Center in LLC

  • Nurse Practitioner
  • Jeffersonville, IN
  • NPI 1720703382

  Family

  Medicare reassignment Care Compare group NPD
• Addiction Wellness Center NH LLC

  • Adult Health Nurse Practitioner
  • Manchester, NH
  • NPI 1639866197
  Medicare reassignment Care Compare group NPD
• Community Medical Associates, Inc.

  • Internal Medicine Physician
  • Louisville, KY
  • NPI 1588614994

  IN

  Medicare reassignment Care Compare group NPD
• Norton - Kings Daughters Health Inc

  dba Norton King's Daughters' Health

  • Family Medicine Physician
  • Madison, IN
  • NPI 1114955093
  Medicare reassignment NPD
• CCMH Corporation

  dba Carroll County Memorial Hospital

  • Critical Access Hospital
  • Carrollton, KY
  • NPI 1225159601
  Medicare reassignment NPD
• Norton - Kings Daughters Health Inc

  dba Kings Daughters Health

  • Clinical Medical Laboratory
  • Madison, IN
  • NPI 1497024426
  NPD
• Tristate Pathology and Forensic Services LLC

  • Anatomic Pathology & Clinical Pathology Physician
  • Lawrenceburg, IN
  • NPI 1649720244
  NPD
• CCMH Corporation

  dba CCMH Surgical Practice

  • Surgery Physician
  • Carrollton, KY
  • NPI 1528255692

  Family

  NPD
• CCMH Corporation

  dba CCMH Outpatient Pharmacy

  • Community/Retail Pharmacy
  • Carrollton, KY
  • NPI 1760149413
  NPD
• Community Medical Associates, Inc.

  dba Norton Emergency Medicine

  • Emergency Medicine Physician
  • Louisville, KY
  • NPI 1679275440

  Family

  NPD
• Community Medical Associates, Inc.

  dba Norton Community Medical Associates

  • Internal Medicine Physician
  • Louisville, KY
  • NPI 1881192409
  NPD
• Community Medical Associates, Inc.

  • Neurological Surgery Physician
  • Louisville, KY
  • NPI 1922288760
  NPD (past)

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

• Norton - Kings Daughters Health Inc

  dba Kings Daughters Health

  • Clinical Medical Laboratory
  • Madison, IN
  • NPI 1497024426

  Hospital

  Care Compare affiliation
• Norton - Kings Daughters Health Inc

  dba Kings Daughters Health

  • Land Ambulance
  • Madison, IN
  • NPI 1891855045

  Hospital

  Care Compare affiliation
• Norton - Kings Daughters Health, Inc

  dba Kings Daughters Health

  • General Acute Care Hospital
  • Madison, IN
  • NPI 1518916048
  Care Compare affiliation

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

{
    "created_epoch": "1703721600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1762387200000",
    "number": "1639948946",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8535 E PHILLIP DR",
            "city": "VEVAY",
            "state": "IN",
            "postal_code": "470439478",
            "telephone_number": "765-620-6600"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1373 E STATE ROAD 62",
            "city": "MADISON",
            "state": "IN",
            "postal_code": "472507328",
            "telephone_number": "812-801-0152",
            "fax_number": "812-801-0150"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "309 11th St",
            "address_purpose": "LOCATION",
            "city": "Carrollton",
            "state": "KY",
            "postal_code": "410081435",
            "country_code": "US",
            "telephone_number": "502-732-3272",
            "fax_number": "502-732-3284",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2051 Clevidence Blvd Ste A",
            "address_purpose": "LOCATION",
            "city": "Clarksville",
            "state": "IN",
            "postal_code": "471292278",
            "country_code": "US",
            "telephone_number": "812-282-1720",
            "fax_number": "812-280-6636",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "8535 E Phillip Dr",
            "address_purpose": "LOCATION",
            "city": "Vevay",
            "state": "IN",
            "postal_code": "470439478",
            "country_code": "US",
            "telephone_number": "765-620-6600",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "445 Clifty Dr",
            "address_purpose": "LOCATION",
            "city": "Madison",
            "state": "IN",
            "postal_code": "472501607",
            "country_code": "US",
            "telephone_number": "812-273-5372",
            "fax_number": "812-273-5741",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1373 E State Road 62 Ste 2B",
            "address_purpose": "LOCATION",
            "city": "Madison",
            "state": "IN",
            "postal_code": "472507328",
            "country_code": "US",
            "telephone_number": "812-273-5372",
            "fax_number": "812-801-5741",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "3605 Northgate Ct Ste 110",
            "address_purpose": "LOCATION",
            "city": "New Albany",
            "state": "IN",
            "postal_code": "471506400",
            "country_code": "US",
            "telephone_number": "812-949-5749",
            "fax_number": "812-949-5794",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "3118 E 10th St Ste C",
            "address_purpose": "LOCATION",
            "city": "Jeffersonville",
            "state": "IN",
            "postal_code": "471305904",
            "country_code": "US",
            "telephone_number": "812-280-9355",
            "fax_number": "812-285-1487",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1373 E State Road 62",
            "address_purpose": "LOCATION",
            "city": "Madison",
            "state": "IN",
            "postal_code": "472507328",
            "country_code": "US",
            "telephone_number": "812-801-0152",
            "fax_number": "812-801-0150",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DAVIS",
        "first_name": "TRACIE",
        "middle_name": "L",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-12-28",
        "last_updated": "2025-11-06",
        "certification_date": "2025-11-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "IN",
            "license": "71014807A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "300088330",
            "state": "IN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7100963670",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Paul W Cronen Jr., M.D.
• Kristina L Crooks
• Alan P Culbreth, M.D.
• David F Butler, DDS
• Joan Blackwood Davis, HSPP
• Landyn Deckert, OTR/L
• Carleigh Deitsch, OD
• Elizabeth Desonia, COTA
• Tyler Scott Deuser, MBA, ATC, LAT, CSCS
• Cathryn Irene Dhonau, M.S. CCC-SLP

• Family Nurse Practitioner in Madison, IN
• Providers in Madison, IN by specialty
• Family Nurse Practitioner in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 6, 2025; 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.