Individual provider Active NPI

Tracey Ann Pick, ARNP

  • Family Nurse Practitioner
  • South Sioux City, NE
National Provider Identifier
1760444558
Registry record updated Dec 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
110545 Issued in NE
Practice address
3410 Futures Dr
South Sioux City, NE 68776-3917
Phone
(402) 412-7242
Fax
(712) 252-5920
NPI assigned
Apr 5, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 21, 2022

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X 110545 NE
Specialist 174400000X A096027 IA
Specialist 174400000X 0302 SD
Family Nurse Practitioner 363LF0000X 110545 NE Primary

Addresses

Primary practice location

3410 Futures Dr
South Sioux City, NE 68776-3917

Mailing address

1021 Nebraska St
Sioux City, IA 51105-1436
Phone (712) 252-2477

Other practice location 1

501 1st Ave
South Sioux City, NE 68776-1703
Phone (402) 494-3064

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IA, NE2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20100510000670 IA Practitioner - Nurse Practitioner 3274661418 Reassigns benefits to 1 organization
I20170426000572 NE Practitioner - Nurse Practitioner 3274661418 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Siouxland Community Health Center CurrentSince Jan 2, 2023 Accepting new patients

Locations

1021 Nebraska St
Sioux City, IA 51105
Phone (712) 252-2477

3410 Futures Dr
South Sioux City, NE 68776
Phone (402) 412-4271

Interoperability endpoints

  • Direct secure messaging: tpick637194@direct.ochin.org

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.

NPI Registry JSON

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

{
    "created_epoch": "1144195200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1671580800000",
    "number": "1760444558",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1021 NEBRASKA ST",
            "city": "SIOUX CITY",
            "state": "IA",
            "postal_code": "511051436",
            "telephone_number": "712-252-2477",
            "fax_number": "712-252-5920"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3410 FUTURES DR",
            "city": "SOUTH SIOUX CITY",
            "state": "NE",
            "postal_code": "687763917",
            "telephone_number": "402-412-7242",
            "fax_number": "712-252-5920"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "501 1st Ave",
            "address_purpose": "LOCATION",
            "city": "South Sioux City",
            "state": "NE",
            "postal_code": "687761703",
            "country_code": "US",
            "telephone_number": "402-494-3064",
            "fax_number": "712-294-7299",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PICK",
        "first_name": "TRACEY",
        "middle_name": "ANN",
        "credential": "ARNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-04-05",
        "last_updated": "2022-12-21",
        "certification_date": "2022-12-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "NE",
            "license": "110545",
            "primary": false
        },
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "IA",
            "license": "A096027",
            "primary": false
        },
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "SD",
            "license": "0302",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NE",
            "license": "110545",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in South Sioux City, NE

Sources for this page

Verify at the official NPI Registry.