Tracy Kelly Davis

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

Practice address

1321 McMillan Ave
Brewton, AL 36426-1324

Phone

(251) 867-3242

Fax

(251) 867-7151

NPI assigned

Aug 8, 2022

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

Medicare fee-for-service enrollment

Enrolled in AL

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://api.qualifacts.org/api/fhir/swamh/r4/

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.

• Southwest Alabama Behavioral Health Care Systems

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Monroeville, AL
  • NPI 1881628162

  AL

  Medicare reassignment NPD
• Southwest Alabama Behavioral Health Care Systems

  • Community/Behavioral Health Agency
  • Monroeville, AL
  • NPI 1215104682
  NPD (past)

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

{
    "created_epoch": "1659916800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1659916800000",
    "number": "1962139089",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 964",
            "city": "MONROEVILLE",
            "state": "AL",
            "postal_code": "364610964",
            "telephone_number": "251-575-4203",
            "fax_number": "251-575-9459"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1321 MCMILLAN AVE",
            "city": "BREWTON",
            "state": "AL",
            "postal_code": "364261324",
            "telephone_number": "251-867-3242",
            "fax_number": "251-867-7151"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAVIS",
        "first_name": "TRACY",
        "middle_name": "KELLY",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-08-08",
        "last_updated": "2022-08-08",
        "certification_date": "2022-08-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• D. W. McMillan Memorial Hospital
• D. W. McMillan Memorial Hospital
• D.W. McMillan Memorial Hospital
• D.W. McMillan Memorial Hospital / Escambia County Health Authority
• Tolondonakia Rachelle Daniels
• James Randall Deatherage
• Robert Anthony Defrancisco, PHD
• Dependable Home Healthcare Services
• Dialysis Affiliates of South Alabama
• DW McMillan Memorial Hospital

• Mental Health Counselor in Brewton, AL
• Providers in Brewton, AL by specialty
• Mental Health Counselor in Alabama

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 8, 2022; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.