Tracey R Hammack, NP

Key facts

NPI

1710144571

Entity type

Individual (NPI type 1)

Primary specialty

Family Nurse Practitioner 363LF0000X

License

858974 (MS)

Practice address

2819 Denny Ave
Pascagoula, MS 39581-5301

Phone

(228) 762-3466

Fax

(228) 762-6349

NPI assigned

May 20, 2008

Sex

Female

Sole proprietor

No

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.

• Mobile Emergency Physicians, LLC Emergency Medicine Physician · Mobile, AL · NPI 1881934982
  Medicare reassignment NPD AL
• St. John Emergency Group LLC Emergency Medicine Physician · La Place, LA · NPI 1265401509
  Medicare reassignment NPD LA
• Van Meter Emergency Physicians Inc. Apmc Emergency Medicine Physician · Covington, LA · NPI 1649410697
  Medicare reassignment NPD LA
• American Family Care, LLC Family Medicine Physician · Vestavia Hills, AL · NPI 1265210645
  NPD (past)

Medicare participation

Medicare fee-for-service enrollment

Enrolled (2 enrollments) in LA, AL

Eligible to order & refer

Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No

Medicare enrollment records

National Provider Directory

Medicare enrollment (NPD)

Yes

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://api.platform.athenahealth.com/14272/brand/70/csg/1/fhir/r4

Specialties & licenses

Addresses

Other names

• Tracey R Avinger Former name

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on Apr 17, 2023.

{
    "created_epoch": "1211241600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1681689600000",
    "number": "1710144571",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2101 HIGHWAY 90",
            "city": "GAUTIER",
            "state": "MS",
            "postal_code": "395535340",
            "telephone_number": "228-497-7576",
            "fax_number": "229-497-8869"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2819 DENNY AVE",
            "city": "PASCAGOULA",
            "state": "MS",
            "postal_code": "395815301",
            "telephone_number": "228-762-3466",
            "fax_number": "228-762-6349"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HAMMACK",
        "first_name": "TRACEY",
        "middle_name": "R",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-05-20",
        "last_updated": "2023-04-17",
        "certification_date": "2023-04-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MS",
            "license": "858974",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "TRACEY",
            "last_name": "AVINGER",
            "middle_name": "R",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

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All providers in Pascagoula, MS · Family Nurse Practitioner in Mississippi