Individual provider Active NPI

Tracy Greene, NP-C

  • Family Nurse Practitioner
  • Safety Harbor, FL
National Provider Identifier
1700193737
Registry record updated Dec 11, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
ARNP9384048 Issued in FL
Practice address
531 Main St
Ste K
Safety Harbor, FL 34695-3558
Phone
(727) 831-8376
Fax
(727) 265-3420
NPI assigned
Sep 13, 2010
Last updated
Dec 11, 2020By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 11, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 11672-NP OH
Family Nurse Practitioner 363LF0000X ARNP9384048 FL Primary

Addresses

Primary practice location

531 Main St
Ste K
Safety Harbor, FL 34695-3558

Mailing address

531 Main St
Ste K
Safety Harbor, FL 34695-3558
Phone (727) 831-8376

Other names 1

  • Tracy Conley 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
I20140820002501 FL Practitioner - Nurse Practitioner 4880887645 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

5647 Main St
New Port Richey, FL 34652-2641
Phone (727) 831-8376

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
11672-NPOHMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Carelon Medical Partners of Kansas, PA Past Accepting new patients

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.

NPI Registry JSON

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

{
    "created_epoch": "1284336000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1607644800000",
    "number": "1700193737",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "531 MAIN ST",
            "address_2": "STE K",
            "city": "SAFETY HARBOR",
            "state": "FL",
            "postal_code": "346953558",
            "telephone_number": "727-831-8376",
            "fax_number": "727-265-3420"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "531 MAIN ST",
            "address_2": "STE K",
            "city": "SAFETY HARBOR",
            "state": "FL",
            "postal_code": "346953558",
            "telephone_number": "727-831-8376",
            "fax_number": "727-265-3420"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GREENE",
        "first_name": "TRACY",
        "credential": "NP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-09-13",
        "last_updated": "2020-12-11",
        "certification_date": "2020-12-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "OH",
            "license": "11672-NP",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "FL",
            "license": "ARNP9384048",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "TRACY",
            "last_name": "CONLEY",
            "credential": "NP-C",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Safety Harbor, FL

Sources for this page

Verify at the official NPI Registry.