Individual provider Active NPI

Ellen Marie Tracy, DNP, FNP

  • Nurse Practitioner
  • Saint Louis, MO
National Provider Identifier
1760005367
Registry record updated Sep 19, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
2024013672 Issued in MO
Practice address
1110 Highlands Plaza Drive East Suite220
Saint Louis, MO 63110-3927
Phone
(314) 448-3791
NPI assigned
May 19, 2020
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 19, 2025

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X RN500006857 DC
Nurse Practitioner 363L00000X 2024013672 MO Primary
Family Nurse Practitioner 363LF0000X NP500006857 DC

Addresses

Primary practice location

1110 Highlands Plaza Drive East Suite220
Saint Louis, MO 63110-3927

Mailing address

660 Mason Ridge Center Drive Ste 300
Saint Louis, MO 63141
Phone (314) 448-3791

Other practice location 1

845 Bladensburg Rd NE
Washington, DC 20002-3927
Phone (202) 397-2600

Other practice location 2

1202 Jackson St NE Apt 109
Washington, DC 20017-4009
Phone (217) 494-6234

Electronic endpoints 1

TypeEndpointUseAffiliation
FHIR URL https://epicproxy.et0965.epichosted.com/FHIRProxy/api/FHIR/DSTU2/ Health Information Exchange (HIE)

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20240605001674 MO Practitioner - Nurse Practitioner 4981078979 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Physician Groups LCGroup PAC ID 3072421254, 526 clinicians

Practice addresses (Care Compare)

1110 Highlands Plaza Dr E
Saint Louis, MO 63110-1351
Phone (314) 273-0195

2630 Hwy K
O Fallon, MO 63368-6624
Phone (636) 240-5454

Hospital & facility affiliations

  • SSM Health Rehabilitation Hospital Inpatient rehabilitation facility, Richmond Heights, MO, CCN 263031

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
RN500006857DCMDRegistered Nurse
NP500006857DCMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Physician Groups LC CurrentSince Jul 1, 2024 Accepting new patients
Physician Groups LC CurrentSince Jul 1, 2024 Accepting new patients

Locations

2630 Highway K
O Fallon, MO 63368
Phone (636) 240-5454

660 Mason Ridge Center Dr
Ste 300
Saint Louis, MO 63141
Phone (314) 463-6950

1110 Highlands Plaza Dr E
Ste 220
Saint Louis, MO 63110
Phone (314) 273-0195

Organizations & group practices 2

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.

Hospital & facility affiliations 1

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": "1589846400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1758240000000",
    "number": "1760005367",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "660 MASON RIDGE CENTER DRIVE STE 300",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "63141",
            "telephone_number": "314-448-3791",
            "fax_number": "314-996-7658"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1110 HIGHLANDS PLAZA DRIVE EAST SUITE220",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631103927",
            "telephone_number": "314-448-3791"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "845 Bladensburg Rd NE",
            "address_purpose": "LOCATION",
            "city": "Washington",
            "state": "DC",
            "postal_code": "200023927",
            "country_code": "US",
            "telephone_number": "202-397-2600",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1202 Jackson St NE Apt 109",
            "address_purpose": "LOCATION",
            "city": "Washington",
            "state": "DC",
            "postal_code": "200174009",
            "country_code": "US",
            "telephone_number": "217-494-6234",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "TRACY",
        "first_name": "ELLEN",
        "middle_name": "MARIE",
        "credential": "DNP, FNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-05-19",
        "last_updated": "2025-09-19",
        "certification_date": "2025-09-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "DC",
            "license": "RN500006857",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "MO",
            "license": "2024013672",
            "primary": true
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "DC",
            "license": "NP500006857",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://epicproxy.et0965.epichosted.com/FHIRProxy/api/FHIR/DSTU2/",
            "affiliation": "N",
            "endpointDescription": "BJC",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "1110 Highlands Plaza Drive East Suite220",
            "city": "Saint Louis",
            "state": "MO",
            "country_code": "US",
            "postal_code": "631103927",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Saint Louis, MO

Sources for this page

Verify at the official NPI Registry.