Tracy Thomas Phillips, D.O.

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

E1018 Issued in AR

Practice address

2001 Club Manor Dr Ste S
Maumelle, AR 72113-7417

Phone

(501) 734-8085

Fax

(501) 734-8088

NPI assigned

Jul 12, 2005

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 3

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in AR

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Not enrolled

HHS exclusion list flag

Flagged The directory lists this NPI on an HHS exclusion list. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.

Credentials

Doctor of Osteopathy

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: tracy.phillips@pfm-ar.direct.office.nextgen.com

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Tiffany Lack, APRN, FNP-BC

  • Family Nurse Practitioner
  • Maumelle, AR
  • NPI 1700431723
  Medicare reassignment

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.

• Ess of Fordyce LLC

  • Emergency Medicine Physician
  • Fordyce, AR
  • NPI 1821547977
  Medicare reassignment NPD
• Ess of McGehee LLC

  • Emergency Medicine Physician
  • MC Gehee, AR
  • NPI 1639822653
  Medicare reassignment NPD
• HCC of Magnolia LLC

  • Hospitalist Physician
  • Magnolia, AR
  • NPI 1831865872
  Medicare reassignment NPD
• Hospital Care Consultants of Fordyce LLC

  • Hospitalist Physician
  • Fordyce, AR
  • NPI 1316497464
  Medicare reassignment NPD
• Emergency Staffing Solutions Region III

  • Emergency Medicine Physician
  • Dallas, TX
  • NPI 1689967895

  AR

  Medicare reassignment NPD
• HCC of Warren Hospitalist LLC

  • Emergency Medicine Physician
  • Warren, AR
  • NPI 1326641606
  NPD
• HCC of Warren LLC

  • Hospitalist Physician
  • Warren, AR
  • NPI 1952904237
  NPD
• St Marys Physician Services, LLC

  dba Cardiology Associates of North Central Arkansas

  • Interventional Cardiology Physician
  • Russellville, AR
  • NPI 1720356207
  NPD (past)

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

{
    "created_epoch": "1121126400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1716940800000",
    "number": "1679571863",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 13554",
            "city": "MAUMELLE",
            "state": "AR",
            "postal_code": "721130554",
            "telephone_number": "501-350-8505",
            "fax_number": "501-488-1020"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2001 CLUB MANOR DR STE S",
            "city": "MAUMELLE",
            "state": "AR",
            "postal_code": "721137417",
            "telephone_number": "501-734-8085",
            "fax_number": "501-734-8088"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PHILLIPS",
        "first_name": "TRACY",
        "middle_name": "THOMAS",
        "credential": "D.O.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-07-12",
        "last_updated": "2024-05-29",
        "certification_date": "2024-05-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": "AR",
            "license": "E1018",
            "primary": false
        },
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": "AR",
            "license": "E-1018",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "AR",
            "license": "E1018",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "129995003",
            "state": "AR"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE",
            "identifier": "2Z0853",
            "state": "AR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• PCM Chiropractic, PA (Power Chiropractic 4)
• Peace at Home Caregivers LLC (SYNERGY HomeCare of Maumelle)
• Adam Perry
• Yolanda Latrece Peyton, M.S.,CCC-SLP
• Pharmacy Operations, Inc (Medicine Shoppe)
• Tyler Pitchford, PHARM.D.
• Anna Prewitt, APRN
• Daniel P. Pritchett, M.D.
• Promed Logistics, LLC
• Angela D. Pruitt, LCSW

• Family Medicine Physician in Maumelle, AR
• Providers in Maumelle, AR by specialty
• Family Medicine Physician in Arkansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 29, 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.