Individual provider Active NPI

Tracy P Murray, MD

  • Family Medicine Physician
  • Lawrenceville, GA
National Provider Identifier
1942494307
Registry record updated Sep 2, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
01064312A Issued in IN
Practice address
771 Old Norcross Rd Ste 225
Lawrenceville, GA 30046-4982
Phone
(770) 442-1911
Fax
(770) 407-2059
NPI assigned
Aug 29, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 2, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 01064312A IN Primary

Addresses

Primary practice location

771 Old Norcross Rd Ste 225
Lawrenceville, GA 30046-4982

Mailing address

342 Blue Creek LN
Loganville, GA 30052-7839

Other identifiers 1

IdentifierTypeStateIssuer
200875020MedicaidIN

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IN, GA2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20071002000254 IN Practitioner - Family Practice 0941395248 Reassigns benefits to 1 organization
I20210707002901 GA Practitioner - Family Practice 0941395248 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
01064312AINMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
University Family Physicians, Inc. CurrentSince Apr 1, 2012 Accepting new patients
Southeast Medical Group, P.C. Family Medicine CurrentSince Mar 21, 2021 Accepting new patients
University Family Physicians, Inc. Family Medicine CurrentSince Apr 1, 2012 Accepting new patients
Major Hospital Past Accepting new patients

Locations

3400 Old Milton Pkwy
Ste C270
Alpharetta, GA 30005
Phone 7704421911233

1255 Friendship Rd
Ste 130
Braselton, GA 30517
Phone (678) 341-6350

771 Old Norcross Rd
Ste 225
Lawrenceville, GA 30046
Phone (678) 802-4045

7216 Solutions Ctr
Chicago, IL 60677

1115 Ronald Reagan Pkwy
Ste 141
Avon, IN 46123
Phone (317) 217-2700

250 N Shadeland Ave
Ste 130
Indianapolis, IN 46219
Phone (317) 962-4836

250 N Shadeland Ave
Ste 200
Indianapolis, IN 46219
Phone (317) 962-4836

5515 W 38th St
Indianapolis, IN 46254
Phone (317) 880-3838

720 Eskenazi Ave
Fl 5
Indianapolis, IN 46202
Phone (317) 880-6000

1520 N Senate Ave
Indianapolis, IN 46202
Phone (317) 962-0857

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/DIJIBA

Organizations & group practices 4

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": "1188345600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1630540800000",
    "number": "1942494307",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "342 BLUE CREEK LN",
            "city": "LOGANVILLE",
            "state": "GA",
            "postal_code": "300527839"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "771 OLD NORCROSS RD STE 225",
            "city": "LAWRENCEVILLE",
            "state": "GA",
            "postal_code": "300464982",
            "telephone_number": "770-442-1911",
            "fax_number": "770-407-2059"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MURRAY",
        "first_name": "TRACY",
        "middle_name": "P",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-08-29",
        "last_updated": "2021-09-02",
        "certification_date": "2021-09-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "IN",
            "license": "01064312A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200875020",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Lawrenceville, GA

Sources for this page

Verify at the official NPI Registry.