Active NPI
Tracy Ann Antoneth Spence, APRN, PMHNP
- Psychiatric/Mental Health Nurse Practitioner
- Fort Lauderdale, FL
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychiatric/Mental Health Nurse Practitioner
- License
- APRN11023811
- Practice address
- 4546 N Federal Hwy
Fort Lauderdale, FL 33308-5204 - Phone
- (954) 716-6514
- Fax
- (954) 564-1371
- NPI assigned
- Feb 13, 2023
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Registered Nurse | 163W00000X | RN9366980 | FL | |
| Psychiatric/Mental Health Nurse Practitioner | 363LP0808X | APRN11023811 | FL | Primary |
Addresses
Primary practice location
4546 N Federal Hwy
Fort Lauderdale, FL 33308-5204
Mailing address
4546 N Federal Hwy
Fort Lauderdale, FL 33308-5204
Phone (954) 716-6514
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| APRN11023811 | Other | FL | STATE LICENSE |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in FL
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: No
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Nurse Practitioner
- Education
- Other, 2022
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
- Group practices
Practice addresses (Care Compare)
2808 NE 22ND St
Fort Lauderdale, FL 33305-2804
4546 N Federal Hwy
Fort Lauderdale, FL 33308-5204
Phone (954) 716-6514
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| RN9366980 | FL | MD | Registered Nurse |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Grow Healthcare Group PA | Psychiatric/Mental Health | Current | Accepting new patients |
| Theracounsel, Inc. | Current | Accepting new patients |
Locations
4546 N Federal Hwy
Ft Lauderdale, FL 33308
Phone (954) 328-6163
66 W Flagler St
Ste 900
Miami, FL 33130
Phone (786) 244-7711
Organizations & group practices 2
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.
-
- Clinical Social Worker
- Ft Lauderdale, FL
- NPI 1457460339
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1676246400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1679184000000",
"number": "1952008757",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4546 N FEDERAL HWY",
"city": "FORT LAUDERDALE",
"state": "FL",
"postal_code": "333085204",
"telephone_number": "954-716-6514",
"fax_number": "954-564-1371"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4546 N FEDERAL HWY",
"city": "FORT LAUDERDALE",
"state": "FL",
"postal_code": "333085204",
"telephone_number": "954-716-6514",
"fax_number": "954-564-1371"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SPENCE",
"first_name": "TRACY",
"middle_name": "ANN ANTONETH",
"name_prefix": "Mrs.",
"credential": "APRN, PMHNP",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2023-02-13",
"last_updated": "2023-03-19",
"certification_date": "2023-03-19",
"status": "A"
},
"taxonomies": [
{
"code": "163W00000X",
"taxonomy_group": "",
"desc": "Registered Nurse",
"state": "FL",
"license": "RN9366980",
"primary": false
},
{
"code": "363LP0808X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Psychiatric/Mental Health",
"state": "FL",
"license": "APRN11023811",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "STATE LICENSE",
"identifier": "APRN11023811",
"state": "FL"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Fort Lauderdale, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 19, 2023; 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.