Individual provider Active NPI

Darcy Racoff Glascock, N.P.

  • Family Nurse Practitioner
  • Canton, GA
National Provider Identifier
1851762801
Registry record updated Dec 23, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
RN203792 Issued in GA
Practice address
6120 Hickory Flat Hwy
Canton, GA 30115-7252
Phone
(770) 720-0610
NPI assigned
Oct 16, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 23, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X RN203792 GA Primary

Addresses

Primary practice location

6120 Hickory Flat Hwy
Canton, GA 30115-7252

Mailing address

6120 Hickory Flat Hwy
Canton, GA 30115-7252
Phone (770) 720-0610

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA
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
I20190405001132 GA Practitioner - Nurse Practitioner 5092056770 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Primary Care PLLCGroup PAC ID 0941642169, 19 clinicians
Minuteclinic LLCGroup PAC ID 6709850241, 576 clinicians

Practice addresses (Care Compare)

11710 Alpharetta Hwy
Roswell, GA 30076-3807
Phone (866) 389-2727

4895 Post Rd
Cumming, GA 30040-4978
Phone (866) 389-2727

6120 Hickory Flat Hwy
Canton, GA 30115-7252
Phone (866) 389-2727

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
RN203792GAMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Primary Care PLLC Family CurrentSince Oct 4, 2024 Accepting new patients
Minuteclinic LLC Family CurrentSince Jan 15, 2021 Accepting new patients
Margaret Ellis, MD, LLC PastSince Mar 1, 2019 Accepting new patients

Locations

6120 Hickory Flat Hwy
Canton, GA 30115
Phone (770) 720-0610

11710 Alpharetta Hwy
Roswell, GA 30076
Phone (770) 754-0141

7207 Rockbridge Rd
Stone Mtn, GA 30087
Phone (770) 469-2002

Networks

  • Healthfirst Medicare Network H1722
  • Healthfirst Medicare Network H9678
  • Healthfirst Medicare Network H3359
  • Healthfirst Medicare Network H5989

Organizations & group practices 3

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": "1444953600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1608681600000",
    "number": "1851762801",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6120 HICKORY FLAT HWY",
            "city": "CANTON",
            "state": "GA",
            "postal_code": "301157252",
            "telephone_number": "770-720-0610"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6120 HICKORY FLAT HWY",
            "city": "CANTON",
            "state": "GA",
            "postal_code": "301157252",
            "telephone_number": "770-720-0610"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GLASCOCK",
        "first_name": "DARCY",
        "middle_name": "RACOFF",
        "credential": "N.P.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-10-16",
        "last_updated": "2020-12-23",
        "certification_date": "2020-12-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "GA",
            "license": "RN203792",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Canton, GA

Sources for this page

Verify at the official NPI Registry.