Tracey John, P.A.-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

6316 Issued in AZ

Practice address

44572 W. Bowlin Road
Maricopa, AZ 85138-8922

Phone

(480) 216-9417

NPI assigned

Feb 15, 2016

Last updated

Jul 21, 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 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in AZ

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

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

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.

• Banner Urgent Care Arizona LLC

  • Urgent Care Clinic/Center
  • Casa Grande, AZ
  • NPI 1316349855
  Medicare reassignment
• Banner Urgent Care Services, LLC

  • Urgent Care Clinic/Center
  • Scottsdale, AZ
  • NPI 1609229764
  Medicare reassignment
• Banner Urgent Care Arizona LLC

  • Urgent Care Clinic/Center
  • Payson, AZ
  • NPI 1194369074
  NPD
• Banner Urgent Care Services, LLC

  • Urgent Care Clinic/Center
  • Tucson, AZ
  • NPI 1962855031
  NPD
• Sun Life Family Health Center, Inc.

  dba Sun Life Family Health Center

  • Federally Qualified Health Center (FQHC)
  • Mesa, AZ
  • NPI 1508276940
  NPD (past)
• Sun Life Family Health Center, Inc.

  dba Sun Life Family Health Center

  • Federally Qualified Health Center (FQHC)
  • Eloy, AZ
  • NPI 1588876429
  NPD (past)
• Sun Life Family Health Center, Inc.

  • Federally Qualified Health Center (FQHC)
  • Maricopa, AZ
  • NPI 1881073443
  NPD (past)
• Sun Life Family Health Center, Inc.

  dba Sun Life Family Health Center-Florence

  • Federally Qualified Health Center (FQHC)
  • Florence, AZ
  • NPI 1902278252
  NPD (past)

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

{
    "created_epoch": "1455494400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1780043174",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "44572 W. BOWLIN ROAD",
            "city": "MARICOPA",
            "state": "AZ",
            "postal_code": "851388922",
            "telephone_number": "480-216-9417"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "44572 W. BOWLIN ROAD",
            "city": "MARICOPA",
            "state": "AZ",
            "postal_code": "851388922",
            "telephone_number": "480-216-9417"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHN",
        "first_name": "TRACEY",
        "credential": "P.A.-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-02-15",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "AZ",
            "license": "6316",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "114369",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Jared Pope DDS PLC (Progressive Dentistry & Orthodontics)
• Sha-Kyra Alexis Jenkins
• Danielle Jennings, WHNP-BC
• Jho Health LLC
• Joechris Home LLC.
• Claudette Elizabeth Johnson
• Garrett Johnson, PT
• Laury Kay Johnson, R.N.
• Nichelle Rynette Johnson, LPN
• Joint Healing Operations Alpha House LLC

• Physician Assistant in Maricopa, AZ
• Providers in Maricopa, AZ by specialty
• Physician Assistant in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.