Tracy Ann Threat, FNP-BC

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

4704223743 Issued in MI

Practice address

5555 Conner St
Suite 2691
Detroit, MI 48213-3448

Phone

(313) 579-1182

Fax

(313) 579-5128

NPI assigned

Jul 30, 2008

Last updated

Nov 18, 2021By the provider in NPPES

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

Medicare fee-for-service enrollment

Enrolled in MI

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, 2008

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

St Mary Mercy Physician PracticesGroup PAC ID 4587742804, 9 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• St Joe Mercy Hospital System Livonia Hospital, Livonia, MI, CCN 230002
• Henry Ford Health St John Hospital Hospital, Detroit, MI, CCN 230165

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: tracy.threat.1@20091.direct.athenahealth.com
• Direct secure messaging: tthreat856183@direct.trinity-health.org

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.

• St Mary Mercy Physician Practices

  • Multi-Specialty Clinic/Center
  • Livonia, MI
  • NPI 1568630077
  Medicare reassignment Care Compare group NPD
• St Mary Mercy Physician Practices

  dba St. Joe's Urgent Care - Livonia

  • Urgent Care Clinic/Center
  • Livonia, MI
  • NPI 1184154544
  NPD
• St Mary Mercy Physician Practices

  • Family Medicine Physician
  • Detroit, MI
  • NPI 1801303086
  NPD

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

• St Mary Mercy Hospital

  • General Acute Care Hospital
  • Livonia, MI
  • NPI 1790706901
  Care Compare affiliation
• Henry Ford Health St. John Hospital

  dba St John Hospital and Medical Center

  • General Acute Care Hospital
  • Chicago, IL
  • NPI 1023088168
  Care Compare affiliation

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

{
    "created_epoch": "1217376000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1637193600000",
    "number": "1891951711",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5555 CONNER ST STE 2691",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482133812",
            "telephone_number": "313-692-8400",
            "fax_number": "313-692-8427"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5555 CONNER ST",
            "address_2": "SUITE 2691",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482133448",
            "telephone_number": "313-579-1182",
            "fax_number": "313-579-5128"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "211 Glendale St",
            "address_purpose": "LOCATION",
            "city": "Highland Park",
            "state": "MI",
            "postal_code": "482033231",
            "country_code": "US",
            "telephone_number": "313-758-6100",
            "fax_number": "313-524-2050",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "THREAT",
        "first_name": "TRACY",
        "middle_name": "ANN",
        "credential": "FNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-07-30",
        "last_updated": "2021-11-18",
        "certification_date": "2021-11-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "MI",
            "license": "4704223743",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CAQH ID",
            "identifier": "11971276",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Tracy Journee Thornton, CPT, J.D.
• Yasmin Thornton
• Maya Thottakath
• Dawn Louise Thrasher, ATC, NASM-PES
• Jacob Thrasher, LLMSW
• Deborah L Threatt, MA, LBSW, CFLE
• Stephania Threatt
• Three Men and a Couch Counseling and Therapy
• Three Queens Home Health Care LLC
• Andre Threlkeld

• Nurse Practitioner in Detroit, MI
• Providers in Detroit, MI by specialty
• Nurse Practitioner in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 18, 2021; 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.