Tracy Lynn Boetto, FNP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

5011024 Issued in NC

Practice address

5303 Poplar Tent Rd Ste 90
Concord, NC 28027-9720

Phone

(980) 866-4493

NPI assigned

Sep 25, 2018

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in NC

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, 2018

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Carolina Medicorp Enterprises LLCGroup PAC ID 0648174904, 184 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: tboetto441407@direct.novanthealth.org

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.

• Carolina Medicorp Enterprises, LLC

  • Urgent Care Clinic/Center
  • Charlotte, NC
  • NPI 1760950646

  NC

  Medicare reassignment Care Compare group NPD
• Afc Urgent Care and Family Care of WNC, PLLC

  • Urgent Care Clinic/Center
  • Charlotte, NC
  • NPI 1679066658

  NC

  Medicare reassignment NPD
• Carolina Medicorp Enterprises, LLC

  • Urgent Care Clinic/Center
  • Asheville, NC
  • NPI 1235014796
  NPD

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

{
    "created_epoch": "1537833600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1720483200000",
    "number": "1780169854",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1012 BAILES RIDGE AVE BLDG APT306",
            "city": "INDIAN LAND",
            "state": "SC",
            "postal_code": "297070088",
            "telephone_number": "704-806-3535"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5303 POPLAR TENT RD STE 90",
            "city": "CONCORD",
            "state": "NC",
            "postal_code": "280279720",
            "telephone_number": "980-866-4493"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "13521 Steelecroft Pkwy Ste B",
            "address_purpose": "LOCATION",
            "city": "Charlotte",
            "state": "NC",
            "postal_code": "282787889",
            "country_code": "US",
            "telephone_number": "704-315-5845",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BOETTO",
        "first_name": "TRACY",
        "middle_name": "LYNN",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-09-25",
        "last_updated": "2024-07-09",
        "certification_date": "2024-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "NC",
            "license": "5011024",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NC",
            "license": "5011024",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• J. Daniel Bobbitt, M.D.
• Marisa Bocklet
• Wesley Winfield Bodie, DO
• Marlee Bodle, CRNA
• Russ A. Bodner, MD
• Michael Sean Boger, MD
• Bailey Nicole Boggs, OTD
• Alexander Vondra Boiwka, M.D.
• Lisa Bolumen, LPC, NCC
• Rebecca Page Bomar, MD

• All providers in Concord, NC
• Family Nurse Practitioner in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2024; 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.