Individual provider Active NPI

Tracy McKenzie

  • Family Nurse Practitioner
  • Princeton, WV
National Provider Identifier
1891171401
Registry record updated Aug 5, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
APRN72764 Issued in WV
Practice address
3997 Beckley Rd
Princeton, WV 24740-7660
Phone
(304) 431-5499
Fax
(304) 431-3400
NPI assigned
Aug 5, 2015
Last updated
Aug 5, 2015By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 5, 2015

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 APRN72764 WV Primary
Registered Nurse 163W00000X 72764 WV

Addresses

Primary practice location

3997 Beckley Rd
Princeton, WV 24740-7660

Mailing address

3997 Beckley Rd
Princeton, WV 24740-7660
Phone (304) 431-5499

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WV
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
I20150916000212 WV Practitioner - Nurse Practitioner 5597072066 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
JC Edwards School of Medicine, Marshall University, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

122 12TH St
Princeton, WV 24740-2312
Phone (304) 487-7936

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
95.34 of 100Reported as apm
Quality
79.86
Promoting interoperability
100
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
APRN72764WVMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Princeton Community Hospital Assn Inc. CurrentSince Aug 1, 2023 Accepting new patients
West Virginia University Medical Corporation CurrentSince Jul 31, 2022 Accepting new patients
Princeton Community Hospital Assn., Inc CurrentSince Aug 1, 2023 Accepting new patients
West Virginia University Medical Corporation CurrentSince Jul 31, 2022 Accepting new patients
Princeton Community Hospital Assn. Inc. Past Accepting new patients
United Physicians Care Inc Past Accepting new patients

Locations

401 E Vermillion St
Athens, WV 24712
Phone (304) 384-7325

16 Sterling Dr
Ste 102
Bridgeport, WV 26330
Phone (681) 342-2133

1 Medical Center Dr
Morgantown, WV 26506
Phone (304) 293-4500

122 12th St
Princeton, WV 24740
Phone (304) 487-7061

218 Undercliff Ter
Princeton, WV 24740
Phone (304) 327-1890

Organizations & group practices 6

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": "1438732800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1438732800000",
    "number": "1891171401",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3997 BECKLEY RD",
            "city": "PRINCETON",
            "state": "WV",
            "postal_code": "247407660",
            "telephone_number": "304-431-5499",
            "fax_number": "304-431-3400"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3997 BECKLEY RD",
            "city": "PRINCETON",
            "state": "WV",
            "postal_code": "247407660",
            "telephone_number": "304-431-5499",
            "fax_number": "304-431-3400"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCKENZIE",
        "first_name": "TRACY",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-08-05",
        "last_updated": "2015-08-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "WV",
            "license": "APRN72764",
            "primary": true
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "WV",
            "license": "72764",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Princeton, WV

Sources for this page

Verify at the official NPI Registry.