Individual provider Active NPI

Tracy Lee Adams, DNP, ARNP, FNP-C

  • Family Nurse Practitioner
  • Panama City, FL
National Provider Identifier
1659854958
Registry record updated Feb 27, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
ARNP3400512 Issued in FL
Practice address
2100 State Ave
Panama City, FL 32405-4587
Phone
(850) 763-0036
Fax
(850) 763-0259
NPI assigned
Sep 12, 2018
Last updated
Feb 27, 2023By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 27, 2023

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 ARNP3400512 FL Primary

Addresses

Primary practice location

2100 State Ave
Panama City, FL 32405-4587

Mailing address

5701 Bayou George Rd
Panama City, FL 32404-5052
Phone (850) 763-0019

Other practice location 1

1847 Florida Ave
Panama City, FL 32405-4640
Phone (850) 914-8600

Other identifiers 1

IdentifierTypeStateIssuer
111417100MedicaidFL

Other names 1

  • Miss Tracy Lee Clark Former name

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
I20190130001668 FL Practitioner - Nurse Practitioner 0446597397 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Ocala Oncology Center PLGroup PAC ID 6901950856, 23 clinicians

Practice addresses (Care Compare)

2100 State Ave
Panama City, FL 32405-4587
Phone (850) 763-0036

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
ARNP3400512FLMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Ocala Oncology Center, PL CurrentSince Jan 3, 2022 Accepting new patients
Ocala Oncology Center PL Family CurrentSince Jan 3, 2022 Accepting new patients

Locations

13940 N US Highway 441
Ste 203
Lady Lake, FL 32159
Phone (352) 259-8940

2100 State Ave
Panama City, FL 32405
Phone (850) 763-0036

Interoperability endpoints

  • Direct secure messaging: tracy.adams@fca.ikm.direct-ci.com

Organizations & group practices 3

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 3

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": "1536710400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1677456000000",
    "number": "1659854958",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5701 BAYOU GEORGE RD",
            "city": "PANAMA CITY",
            "state": "FL",
            "postal_code": "324045052",
            "telephone_number": "850-763-0019"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2100 STATE AVE",
            "city": "PANAMA CITY",
            "state": "FL",
            "postal_code": "324054587",
            "telephone_number": "850-763-0036",
            "fax_number": "850-763-0259"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1847 Florida Ave",
            "address_purpose": "LOCATION",
            "city": "Panama City",
            "state": "FL",
            "postal_code": "324054640",
            "country_code": "US",
            "telephone_number": "850-914-8600",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ADAMS",
        "first_name": "TRACY",
        "middle_name": "LEE",
        "name_prefix": "Dr.",
        "credential": "DNP, ARNP, FNP-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-09-12",
        "last_updated": "2023-02-27",
        "certification_date": "2023-02-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "FL",
            "license": "ARNP3400512",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "111417100",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "TRACY",
            "last_name": "CLARK",
            "middle_name": "LEE",
            "prefix": "MISS",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Panama City, FL

Sources for this page

Verify at the official NPI Registry.