Individual provider Active NPI

Tracy Ann Cushing, PMHNP-BC

  • Psychiatric/Mental Health Nurse Practitioner
  • Richmond Heights, MO
National Provider Identifier
1881917342
Registry record updated Feb 27, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
2020030799 Issued in MO
Practice address
1034 S Brentwood Blvd Ste 1250
Richmond Heights, MO 63117-1263
Phone
(314) 328-7958
NPI assigned
Mar 11, 2010
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 27, 2025

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 2010010163 MO
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 277002208 IL
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 2020030799 MO Primary

Addresses

Primary practice location

1034 S Brentwood Blvd Ste 1250
Richmond Heights, MO 63117-1263

Mailing address

331 Sycamore Pointe Dr
Troy, MO 63379-3590
Phone (314) 602-2704

Other practice location 1

400 S Kingshighway Blvd
Dept Emergency Med
Saint Louis, MO 63110-1014
Phone (314) 362-9123

Other identifiers 1

IdentifierTypeStateIssuer
424249100MedicaidMO

Electronic endpoints 1

TypeEndpointUseAffiliation
FHIR URL https://epicproxy.et0965.epichosted.com/FHIRProxy/api/FHIR/DSTU2/ Washington University

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MO, IL, NE3 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 3

Enrollment IDStateProvider typePAC IDDetails
I20100813000052 MO Practitioner - Nurse Practitioner 4183758139 Reassigns benefits to 3 organizations
I20210503000391 IL Practitioner - Nurse Practitioner 4183758139 Reassigns benefits to 1 organization
I20250806000679 NE Practitioner - Nurse Practitioner 4183758139 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Mercy Hospital PerryGroup PAC ID 1153777826, 115 clinicians
Mercy East Ambulatory Services LLCGroup PAC ID 2365739240, 102 clinicians
Transitions of Western Illinois IncGroup PAC ID 3173414224, 6 clinicians
Nebraska Peace of Mind Behavioral HealthGroup PAC ID 7517341506, 8 clinicians

Practice addresses (Care Compare)

12 N Kingshighway
100 Wound Care
Perryville, MO 63775-1367
Phone (573) 768-3399

1508 Edgemont Blvd
Primary Care/Convenient Care
Perryville, MO 63775-1231
Phone (573) 768-3220

1722 Clarkson Rd
Chesterfield, MO 63017-4976
Phone (636) 206-2665

206 Hospital LN
Perryville, MO 63775-1382

210 Hospital LN
Perryville, MO 63775-4200

210 Hospital LN
Suite 203
Perryville, MO 63775-1276
Phone (573) 768-3285

212 Hospital LN
Perryville, MO 63775-4204

434 N W St
Perryville, MO 63775-1359
Phone (573) 547-2536

4409 Maine St
Quincy, IL 62305-5849
Phone (217) 223-0413

624 Old Saint Marys Rd
Suite a
Perryville, MO 63775-1844
Phone (573) 768-3284

6301 Orchard St
Suite 3
Lincoln, NE 68505-1807
Phone (402) 520-6616

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
2010010163MOMDFamily Nurse Practitioner
277002208ILMDPsychiatric/Mental Health Nurse Practitioner
2020030799MOMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Nebraska Peace of Mind Behavioral Health Family CurrentSince May 2, 2025 Accepting new patients
Transitions of Western Illinois Inc. CurrentSince Nov 5, 2025 Accepting new patients
Mercy East Ambulatory Services LLC CurrentSince Sep 21, 2020 Accepting new patients
Mercy Hospital Perry CurrentSince Apr 27, 2025 Accepting new patients
Southeastern Emergency Services of Memphis, P.C. Nurse Practitioner CurrentSince Sep 7, 2014 Accepting new patients
Mercy Hospital Perry Current Accepting new patients
Mercy Hospital Perry CurrentSince Apr 27, 2025 Accepting new patients
Proactive Behavioral Health Solutions, Inc. Psychiatric/Mental Health CurrentSince Jan 1, 2025 Accepting new patients
A Knew You and Wellness LLC Past Accepting new patients
BC Missouri Emergency Physicians, LLP Nurse Practitioner Past Accepting new patients

Locations

1 Memorial Dr
#204
Alton, IL 62002
Phone (618) 526-5699

4409 Maine St
Quincy, IL 62305
Phone (217) 223-0423

1722 Clarkson Rd
Chesterfield, MO 63017
Phone (636) 206-2665

1600 E Broadway
Columbia, MO 65201
Phone (573) 632-5000

1212 Weber Rd
Farmington, MO 63640
Phone (573) 756-3662

1101 W Liberty St
Farmington, MO 63640
Phone (573) 705-1272

1225 Graham Rd
Florissant, MO 63031
Phone (314) 653-5630

409 Lafayette Ctr
Manchester, MO 63011
Phone (636) 707-0764

856 Waterbury Falls Dr
Ste 102
O Fallon, MO 63368
Phone (636) 339-1190

1654 Bryan Rd
O Fallon, MO 63368
Phone (636) 344-0433

434 N West St
Perryville, MO 63775
Phone (573) 547-2530

212 Hospital Ln
Ste 205
Perryville, MO 63775
Phone (573) 547-3116

11133 Dunn Rd
Saint Louis, MO 63136
Phone (314) 653-5000

751 Sappington Bridge Rd
Sullivan, MO 63080
Phone (573) 468-1343

901 Patients First Dr
Ste 1200
Washington, MO 63090
Phone (636) 390-1777

Organizations & group practices 10

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": "1268265600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1740614400000",
    "number": "1881917342",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "331 SYCAMORE POINTE DR",
            "city": "TROY",
            "state": "MO",
            "postal_code": "633793590",
            "telephone_number": "314-602-2704",
            "fax_number": "314-747-3338"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1034 S BRENTWOOD BLVD STE 1250",
            "city": "RICHMOND HEIGHTS",
            "state": "MO",
            "postal_code": "631171263",
            "telephone_number": "314-328-7958"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "400 S Kingshighway Blvd",
            "address_2": "Dept Emergency Med",
            "address_purpose": "LOCATION",
            "city": "Saint Louis",
            "state": "MO",
            "postal_code": "631101014",
            "country_code": "US",
            "telephone_number": "314-362-9123",
            "fax_number": "314-747-3338",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CUSHING",
        "first_name": "TRACY",
        "middle_name": "ANN",
        "name_prefix": "Ms.",
        "credential": "PMHNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-03-11",
        "last_updated": "2025-02-27",
        "certification_date": "2025-02-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MO",
            "license": "2010010163",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "IL",
            "license": "277002208",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "MO",
            "license": "2020030799",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "424249100",
            "state": "MO"
        }
    ],
    "endpoints": [
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://epicproxy.et0965.epichosted.com/FHIRProxy/api/FHIR/DSTU2/",
            "affiliation": "Y",
            "affiliationName": "Washington University",
            "address_1": "400 S Kingshighway Blvd",
            "address_2": "Dept Emergency Med",
            "city": "Saint Louis",
            "state": "MO",
            "country_code": "US",
            "postal_code": "631101014",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Richmond Heights, MO

Sources for this page

Verify at the official NPI Registry.