Individual provider Active NPI

Tracey Riney

  • Family Nurse Practitioner
  • Caruthersville, MO
National Provider Identifier
1861927337
Registry record updated Apr 21, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
2006033486 Issued in MO
Practice address
1310 Zaida Ave
Caruthersville, MO 63830-2328
Phone
(573) 922-0260
NPI assigned
Apr 21, 2017
Last updated
Apr 21, 2017By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 21, 2017

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 2006033486 MO Primary

Addresses

Primary practice location

1310 Zaida Ave
Caruthersville, MO 63830-2328

Mailing address

1310 Zaida Ave
Caruthersville, MO 63830-2328
Phone (573) 922-0260

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MO, AR2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20170717002159 MO Practitioner - Nurse Practitioner 5092085530 Reassigns benefits to 2 organizations
I20220421000182 AR Practitioner - Nurse Practitioner 5092085530 Reassigns benefits to 2 organizations

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
St Bernards Physician Clinics IncGroup PAC ID 7012311269, shared by 3 NPIs, 211 clinicians
Pemiscot County Memorial HospitalGroup PAC ID 8426024159, shared by 8 NPIs, 22 clinicians

Practice addresses (Care Compare)

1312 1St St
Kennett, MO 63857-2526
Phone (573) 559-2780

333 Red Wolf Blvd
Jonesboro, AR 72405-9739
Phone (870) 972-8181

946 E Reed St
Hayti, MO 63851-1243

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2006033486MOMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
St Bernards Physician Clinics Inc CurrentSince May 1, 2023 Accepting new patients
St Bernards Physician Clinics, Inc. CurrentSince May 1, 2023 Accepting new patients
Sikeston Emergency Group LLC CurrentSince May 15, 2025 Accepting new patients
St Bernards Physician Clinics Inc Current Accepting new patients
Doctors Health Group, Inc CurrentSince May 1, 2022 Accepting new patients
St Bernards Physician Clinics Inc CurrentSince May 1, 2023 Accepting new patients
Pemiscot County Memorial Hospital Past Accepting new patients

Locations

1001 W Parker Rd
Jonesboro, AR 72404
Phone (870) 336-1700

1005 E Matthews Ave
Jonesboro, AR 72401
Phone (870) 935-1242

333 Red Wolf Blvd
Jonesboro, AR 72405
Phone (870) 207-0405

4000 Linwood Dr
Ste A
Paragould, AR 72450
Phone (870) 239-8503

1312 1st St
Kennett, MO 63857
Phone (573) 559-2780

1312 1st St
Ste B
Kennett, MO 63857
Phone (573) 559-2780

1008 N Main St
Sikeston, MO 63801
Phone (573) 471-1600

Interoperability endpoints

  • Direct secure messaging: triney1@sbpc.medalliesdirect.net

Organizations & group practices 7

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 2

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": "1492732800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1492732800000",
    "number": "1861927337",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1310 ZAIDA AVE",
            "city": "CARUTHERSVILLE",
            "state": "MO",
            "postal_code": "638302328",
            "telephone_number": "573-922-0260"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1310 ZAIDA AVE",
            "city": "CARUTHERSVILLE",
            "state": "MO",
            "postal_code": "638302328",
            "telephone_number": "573-922-0260"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RINEY",
        "first_name": "TRACEY",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2017-04-21",
        "last_updated": "2017-04-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MO",
            "license": "2006033486",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Caruthersville, MO

Sources for this page

Verify at the official NPI Registry.