Individual provider Active NPI

Tracey Myers, FNP-C

  • Family Nurse Practitioner
  • Glendale, AZ
National Provider Identifier
1821570094
Registry record updated Jul 26, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
AP11708 Issued in AZ
Practice address
18555 N 79TH Ave Ste E101
Glendale, AZ 85308-8392
Phone
(602) 648-5444
Fax
(602) 772-3801
NPI assigned
Sep 4, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 26, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X AP11708 AZ Primary
Registered Nurse 163W00000X RN216885 AZ

Addresses

Primary practice location

18555 N 79TH Ave Ste E101
Glendale, AZ 85308-8392

Mailing address

PO Box 80217
Phoenix, AZ 85060-0217
Phone (602) 385-2115

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20190102001325 AZ Practitioner - Nurse Practitioner 8224373733 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

20333 N 19TH Ave
Suite 230
Phoenix, AZ 85027-9901
Phone (602) 772-3800

5620 E Bell Rd
Scottsdale, AZ 85254-5950
Phone (602) 385-2115

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
RN216885AZMDRegistered Nurse
AP11708AZMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Orthopedic Specialists of North America, PLLC CurrentSince Jan 28, 2019 Accepting new patients
Orthopedic Specialists of North America PLLC PastSince May 1, 2021 Accepting new patients

Locations

18555 N 79th Ave
Ste E101
Glendale, AZ 85308
Phone (602) 631-3161

9327 N 3rd St
Ste 300
Phoenix, AZ 85020
Phone (602) 631-3166

3033 N 44th St
Ste 100
Phoenix, AZ 85018
Phone (602) 631-3161

4144 N 44th St
Ste A1
Phoenix, AZ 85018

5620 E Bell Rd
Scottsdale, AZ 85254
Phone (602) 485-3050

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": "1536019200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658793600000",
    "number": "1821570094",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 80217",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850600217",
            "telephone_number": "602-385-2115",
            "fax_number": "480-418-3323"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "18555 N 79TH AVE STE E101",
            "city": "GLENDALE",
            "state": "AZ",
            "postal_code": "853088392",
            "telephone_number": "602-648-5444",
            "fax_number": "602-772-3801"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MYERS",
        "first_name": "TRACEY",
        "credential": "FNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-09-04",
        "last_updated": "2022-07-26",
        "certification_date": "2022-07-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "AZ",
            "license": "AP11708",
            "primary": true
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "AZ",
            "license": "RN216885",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Glendale, AZ

Sources for this page

Verify at the official NPI Registry.