Individual provider Active NPI

Amy Tracy, APRN

  • Psychiatric/Mental Health Nurse Practitioner
  • Cary, NC
National Provider Identifier
1679941322
Registry record updated Mar 18, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
5009477 Issued in NC
Practice address
523 Keisler Dr Ste 202
Cary, NC 27518-7099
Phone
(919) 424-0062
Fax
(919) 704-3674
NPI assigned
Sep 11, 2015
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 18, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 5009477 NC Primary

Addresses

Primary practice location

523 Keisler Dr Ste 202
Cary, NC 27518-7099

Mailing address

523 Keisler Dr Ste 202
Cary, NC 27518-7099
Phone (919) 424-0062

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC
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
I20170724000047 NC Practitioner - Nurse Practitioner 3173832151 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Swift Creek Mental Health ServicesGroup PAC ID 7214355072, 3 clinicians

Practice addresses (Care Compare)

10027 US 70 Hwy W
Clayton, NC 27520-2115

1100 NW Maynard Rd
Suite 140
Cary, NC 27513-8707
Phone (919) 424-0062

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
5009477NCMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Swift Creek Mental Health Services Psychiatric/Mental Health CurrentSince Aug 1, 2020 Accepting new patients
Monarch CurrentSince Jan 27, 2020 Accepting new patients
Monarch CurrentSince Jan 27, 2020 Accepting new patients
Monarch Current Accepting new patients

Locations

350 Pee Dee Ave
Ste 101
Albemarle, NC 28001
Phone (704) 986-1522

800 W Williams St
Ste 231P
Apex, NC 27502
Phone (919) 795-6942

523 Keisler Dr
Ste 202
Cary, NC 27518
Phone (919) 424-0062

1100 NW Maynard Rd
Ste 140
Cary, NC 27513
Phone (919) 428-2766

10027 US 70 Hwy W
Clayton, NC 27520
Phone (919) 424-0062

10027 US 70 Hwy W
Ste C
Clayton, NC 27520
Phone (919) 473-6909

820 Grimes Blvd
Lexington, NC 27292
Phone (336) 224-6071

319 Chapanoke Rd
Ste 120
Raleigh, NC 27603
Phone (919) 322-5911

Interoperability endpoints

  • Direct secure messaging: amytracy.swiftcreekmentalhealthservices@160237.advancedmd-direct.com

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.

NPI Registry JSON

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

{
    "created_epoch": "1441929600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1584489600000",
    "number": "1679941322",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "523 KEISLER DR STE 202",
            "city": "CARY",
            "state": "NC",
            "postal_code": "275187099",
            "telephone_number": "919-424-0062",
            "fax_number": "919-704-3674"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "523 KEISLER DR STE 202",
            "city": "CARY",
            "state": "NC",
            "postal_code": "275187099",
            "telephone_number": "919-424-0062",
            "fax_number": "919-704-3674"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TRACY",
        "first_name": "AMY",
        "name_prefix": "Dr.",
        "credential": "APRN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-09-11",
        "last_updated": "2020-03-18",
        "certification_date": "2020-03-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "NC",
            "license": "5009477",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cary, NC

Sources for this page

Verify at the official NPI Registry.