Individual provider Active NPI

Tracey Pool Simmons, NP

  • Adult Health Nurse Practitioner
  • Asheville, NC
National Provider Identifier
1912187279
Registry record updated Dec 8, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Health Nurse PractitionerTaxonomy code 363LA2200X
License
5003024 Issued in NC
Practice address
90 Southside Ave
Suite 350
Asheville, NC 28801-4160
Phone
(828) 277-4810
NPI assigned
Nov 5, 2007
Last updated
Dec 8, 2016By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 8, 2016

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 5003024 NC
Adult Health Nurse Practitioner 363LA2200X 5003024 NC Primary

Addresses

Primary practice location

90 Southside Ave
Suite 350
Asheville, NC 28801-4160

Mailing address

90 Southside Ave
Suite 350
Asheville, NC 28801-4160

Other identifiers 1

IdentifierTypeStateIssuer
1912187279MedicaidNC

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC
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
I20080304000855 NC Practitioner - Nurse Practitioner 5799860557 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
5003024NCMDAdult Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Theoria Medical Nurse Practitioner CurrentSince Sep 20, 2021 Accepting new patients
Piedmont Community Physicians PC Past Accepting new patients
Theoria Medical Nurse Practitioner Past Accepting new patients

Locations

41800 W 11 Mile Rd
Ste 109
Novi, MI 48375
Phone (833) 578-2763

430 W Health Center Dr
Nags Head, NC 27959
Phone (252) 441-3116

237 Tryon Rd
Rutherfordton, NC 28139
Phone (828) 286-7200

Interoperability endpoints

  • Direct secure messaging: tracey.simmons@1104194268299268.direct.elationemr.com

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1194220800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1481155200000",
    "number": "1912187279",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "90 SOUTHSIDE AVE",
            "address_2": "SUITE 350",
            "city": "ASHEVILLE",
            "state": "NC",
            "postal_code": "288014160"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "90 SOUTHSIDE AVE",
            "address_2": "SUITE 350",
            "city": "ASHEVILLE",
            "state": "NC",
            "postal_code": "288014160",
            "telephone_number": "828-277-4810"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SIMMONS",
        "first_name": "TRACEY",
        "middle_name": "POOL",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-11-05",
        "last_updated": "2016-12-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "NC",
            "license": "5003024",
            "primary": false
        },
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "NC",
            "license": "5003024",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1912187279",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Asheville, NC

Sources for this page

Verify at the official NPI Registry.