Individual provider Active NPI

Tracy Pearl Myers, C-AGNP

  • Primary Care Nurse Practitioner
  • Pine Grove, WV
National Provider Identifier
1821417320
Registry record updated Apr 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Primary Care Nurse PractitionerTaxonomy code 363LP2300X
License
APRN53866NP Issued in WV
Practice address
12960 Shortline Hwy
Pine Grove, WV 26419-8221
Phone
(304) 889-3344
Fax
(304) 889-3366
NPI assigned
Apr 11, 2014
Last updated
Apr 21, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 21, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Primary Care Nurse Practitioner 363LP2300X APRN53866NP WV Primary

Addresses

Primary practice location

12960 Shortline Hwy
Pine Grove, WV 26419-8221

Mailing address

12960 Shortline Hwy
Pine Grove, WV 26419-8221
Phone (304) 889-3344

Other identifiers 1

IdentifierTypeStateIssuer
1821217320OtherWVUNKNOWN

Electronic endpoints 2

TypeEndpointUseAffiliation
Direct Messaging Address tmyers136940@direct.wvuhsdirect.com Health Information Exchange (HIE)
Direct Messaging Address tmyers136940@direct.wvuhsdirect.com Health Information Exchange (HIE)

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WV
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
I20140724001850 WV Practitioner - Nurse Practitioner 4082830211 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Wetzel County Hospital IncGroup PAC ID 4284065400, 49 clinicians

Practice addresses (Care Compare)

12960 Shortline Hwy
Pine Grove, WV 26419-8221
Phone (304) 889-3344

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
95.34 of 100Reported as apm
Quality
79.86
Promoting interoperability
100
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
APRN53866NPWVMDPrimary Care Nurse Practitioner

Interoperability endpoints

  • Direct secure messaging: tmyers136940@direct.wvuhsdirect.com

Organizations & group practices 1

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.

Hospital & facility affiliations 3

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": "1397174400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1650499200000",
    "number": "1821417320",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12960 SHORTLINE HWY",
            "city": "PINE GROVE",
            "state": "WV",
            "postal_code": "264198221",
            "telephone_number": "304-889-3344",
            "fax_number": "304-889-3366"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12960 SHORTLINE HWY",
            "city": "PINE GROVE",
            "state": "WV",
            "postal_code": "264198221",
            "telephone_number": "304-889-3344",
            "fax_number": "304-889-3366"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MYERS",
        "first_name": "TRACY",
        "middle_name": "PEARL",
        "name_prefix": "Mrs.",
        "credential": "C-AGNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-04-11",
        "last_updated": "2022-04-21",
        "certification_date": "2022-04-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP2300X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Primary Care",
            "state": "WV",
            "license": "APRN53866NP",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNKNOWN",
            "identifier": "1821217320",
            "state": "WV"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "tmyers136940@direct.wvuhsdirect.com",
            "affiliation": "N",
            "endpointDescription": "Direct Address",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "12960 Shortline Hwy",
            "city": "Pine Grove",
            "state": "WV",
            "country_code": "US",
            "postal_code": "264198221",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "tmyers136940@direct.wvuhsdirect.com",
            "affiliation": "N",
            "endpointDescription": "Direct Address",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "12960 Shortline Hwy",
            "city": "Pine Grove",
            "state": "WV",
            "country_code": "US",
            "postal_code": "264198221",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Pine Grove, WV

Sources for this page

Verify at the official NPI Registry.