Tracy Southern, APRN

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

2017001675 Issued in MO

Practice address

1717 S Range Line Rd Ste B
Joplin, MO 64804-3224

Phone

(417) 623-2207

NPI assigned

Jan 17, 2017

Last updated

Dec 8, 2022By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Enrolled in MO

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

Specialty

Nurse Practitioner

Education

Other, 2016

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Mercy Clinic Joplin LLCGroup PAC ID 0547300196, 288 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Mercy Hospital Joplin Hospital, Joplin, MO, CCN 260001
• Mercy Hospital Carthage Hospital, Carthage, MO, CCN 261338

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

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.

• Mercy Clinic Joplin LLC

  • Family Medicine Physician
  • Joplin, MO
  • NPI 1215264817
  Medicare reassignment Care Compare group NPD
• Mercy Clinic Joplin LLC

  • Family Medicine Physician
  • Columbus, KS
  • NPI 1043547474
  NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Mercy Hospital Carthage

  • Critical Access Hospital
  • Carthage, MO
  • NPI 1003201955
  Care Compare affiliation
• Mercy Hospital Carthage

  dba Mercy McCune-Brooks Hospital

  • General Acute Care Hospital
  • Carthage, MO
  • NPI 1396012753
  Care Compare affiliation
• Mercy Hospital Joplin

  • General Acute Care Hospital
  • Joplin, MO
  • NPI 1700112745
  Care Compare affiliation

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

{
    "created_epoch": "1484611200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1670457600000",
    "number": "1740726660",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1717 S RANGE LINE RD STE B",
            "city": "JOPLIN",
            "state": "MO",
            "postal_code": "648043224",
            "telephone_number": "417-623-2207"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1717 S RANGE LINE RD STE B",
            "city": "JOPLIN",
            "state": "MO",
            "postal_code": "648043224",
            "telephone_number": "417-623-2207"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "101 W Sycamore St",
            "address_purpose": "LOCATION",
            "city": "Columbus",
            "state": "KS",
            "postal_code": "667251276",
            "country_code": "US",
            "telephone_number": "620-429-2101",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SOUTHERN",
        "first_name": "TRACY",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-01-17",
        "last_updated": "2022-12-08",
        "certification_date": "2022-12-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MO",
            "license": "2013023791",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "KS",
            "license": "79397",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MO",
            "license": "2017001675",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Family Nurse Practitioner in Joplin, MO
• Providers in Joplin, MO by specialty
• Family Nurse Practitioner in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 8, 2022; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.