NPIMap

Individual provider Active NPI

Tracey Nicole McCarthy, DO

  • Obstetrics & Gynecology Physician
  • Bolivia, NC
National Provider Identifier
1679731822
Registry record updated Oct 28, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X
License
2008-02036 Issued in NC
Practice address
584 Hospital Dr
Suite B
Bolivia, NC 28422
Phone
(910) 721-4050
Fax
(910) 721-4051
NPI assigned
May 23, 2008
Last updated
Oct 28, 2020By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 28, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics & Gynecology Physician 207V00000X 2008-02036 NC Primary

Addresses

Primary practice location

584 Hospital Dr
Suite B
Bolivia, NC 28422

Mailing address

PO Box 60447
Charlotte, NC 28260-0447
Phone (704) 384-7840

Other identifiers 1

IdentifierTypeStateIssuer
5911526MedicaidNC

Other names 1

  • Tracey Nicole Layne Former name

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address tmccarthy16719@direct.novanthealth.org

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20090514000238 NC Practitioner - Obstetrics/Gynecology 2163571597 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Obstetrics/Gynecology
Education
Other, 2004
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Novant Health Medical Group, LLCGroup PAC ID 1153234893, 2,413 clinicians

Practice addresses (Care Compare)

584 Hospital Dr NE B
Bolivia, NC 28422-9047
Phone (910) 721-4050

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of the uterus1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

Practice roles

OrganizationSpecialtyStatusNew patients
Novant Health Medical Group, LLC Current Accepting new patients
Novant Health Medical Group, LLC Obstetrics & Gynecology CurrentSince Apr 1, 2009 Accepting new patients
Novant Health Medical Group, LLC CurrentSince Apr 1, 2009 Accepting new patients
Novant Health Medical Group, LLC Past Accepting new patients

Locations

584 Hospital Dr NE
Unit B
Bolivia, NC 28422
Phone (910) 662-9480

14330 Oakhill Park Ln
Ste 200
Huntersville, NC 28078
Phone (704) 316-1265

5145 Sellers Rd
Shallotte, NC 28470
Phone (910) 754-4441

2825 Lyndhurst Ave
Ste 101
Winston Salem, NC 27103
Phone (336) 277-6300

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 8

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": "1211500800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1603843200000",
    "number": "1679731822",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 60447",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282600447",
            "telephone_number": "704-384-7840",
            "fax_number": "704-384-7830"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "584 HOSPITAL DR",
            "address_2": "SUITE B",
            "city": "BOLIVIA",
            "state": "NC",
            "postal_code": "28422",
            "telephone_number": "910-721-4050",
            "fax_number": "910-721-4051"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCCARTHY",
        "first_name": "TRACEY",
        "middle_name": "NICOLE",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-05-23",
        "last_updated": "2020-10-28",
        "certification_date": "2020-09-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "NC",
            "license": "2008-02036",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "5911526",
            "state": "NC"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "tmccarthy16719@direct.novanthealth.org",
            "affiliation": "N",
            "address_1": "584 Hospital Dr",
            "address_2": "Suite B",
            "city": "Bolivia",
            "state": "NC",
            "country_code": "US",
            "postal_code": "28422",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "TRACEY",
            "last_name": "LAYNE",
            "middle_name": "NICOLE",
            "credential": "DO",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Bolivia, NC

Sources for this page

Verify at the official NPI Registry.