Tracey Rollins Grupp, CRNP

Primary specialty

Adult Health Nurse PractitionerTaxonomy code 363LA2200X

License

R229739 Issued in MD

Practice address

12145 Elm St
Princess Anne, MD 21853-1358

Phone

(410) 651-5135

Fax

(410) 651-4682

NPI assigned

Jan 6, 2023

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

Other names 1

• Ms. Tracey Forsythe Former name

Medicare fee-for-service enrollment

Enrolled in MD

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, 2022

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Three Lower Counties Community Services IncGroup PAC ID 3678484300, 74 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Adoration Home Health Home health agency, Salisbury, MD, CCN 217111
• Tidalhealth Home Care Home health agency, Salisbury, MD, CCN 217079
• Tidalhealth Peninsula Regional, Inc Hospital, Salisbury, MD, CCN 210019

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: tracey.grupp.1@3167.direct.athenahealth.com

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.

• Three Lower Counties Community Services, Inc.

  • Federally Qualified Health Center (FQHC)
  • Princess Anne, MD
  • NPI 1154354744
  Medicare reassignment Care Compare group NPD
• Peninsula Nephrology Associates, PA

  • Nephrology Physician
  • Salisbury, MD
  • NPI 1811916976
  Medicare reassignment
• Three Lower Counties Community Services Inc

  • Community/Retail Pharmacy
  • Salisbury, MD
  • NPI 1194768473
  NPD
• Three Lower Counties Community Services, Inc.

  • Federally Qualified Health Center (FQHC)
  • Salisbury, MD
  • NPI 1275405714
  NPD
• Three Lower Counties Community Services, Inc.

  • Federally Qualified Health Center (FQHC)
  • Princess Anne, MD
  • NPI 1407849920
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Amedisys Maryland LLC

  • Home Health Agency
  • Cambridge, MD
  • NPI 1811982069
  Care Compare affiliation Name & address match
• Peninsula Home Care, LLC

  • Home Health Agency
  • Salisbury, MD
  • NPI 1811976418
  Care Compare affiliation
• Tidalhealth Peninsula Regional, Inc.

  • General Acute Care Hospital
  • Salisbury, MD
  • NPI 1780689463
  Care Compare affiliation

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

{
    "created_epoch": "1672963200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1710806400000",
    "number": "1831803642",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1978",
            "city": "SALISBURY",
            "state": "MD",
            "postal_code": "218021978",
            "telephone_number": "410-749-1015",
            "fax_number": "410-749-0654"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12145 ELM ST",
            "city": "PRINCESS ANNE",
            "state": "MD",
            "postal_code": "218531358",
            "telephone_number": "410-651-5135",
            "fax_number": "410-651-4682"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRUPP",
        "first_name": "TRACEY",
        "middle_name": "ROLLINS",
        "name_prefix": "Ms.",
        "credential": "CRNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-01-06",
        "last_updated": "2024-03-19",
        "certification_date": "2024-03-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "MD",
            "license": "R229739",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "119591300",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "TRACEY",
            "last_name": "FORSYTHE",
            "prefix": "MS.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Phillip Daniel Goldsborough
• Janell Good, PA
• Gregorio M. Belloso M.D. P.a.
• Griffin Enterprises LLC
• Michelle Grinberg, DMD
• Cindy Ha, DMD
• Kelly Lynn Haday, RDH
• Michelle Katherine Hall, LCSW-C
• Tra'Naizah Shanee Handy, LMSW
• Ashley Nicole Hare, LMSW

• Adult Health Nurse Practitioner in Princess Anne, MD
• Providers in Princess Anne, MD by specialty
• Adult Health Nurse Practitioner in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 19, 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.