TRACY C POOLE NP - NPI 1912538463 - Nurse Practitioner in Malvern, AR

Q: What is Tracy Poole's NPI number?

The NPI number for Tracy Poole is 1912538463. It was assigned to this individual provider in the NPPES registry on February 3, 2020. The provider is also known as Tracy C. Bradshaw.

Q: What is Tracy Poole's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Gerontology, with taxonomy code 363LG0600X.

Q: When was this NPI record last updated?

The NPPES record for Tracy Poole was last updated on December 27, 2024. NPI Profile syncs with the weekly NPPES data releases published by CMS.

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About Tracy C Poole Np NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

TRACY C POOLE NP (NPI 1912538463) is an individual gerontology provider in Malvern, Arkansas, licensed in Arkansas (123708) and active in the NPI registry since February 2020. She is enrolled in Medicare PECOS, maintains 2 additional practice locations, and is a graduate of Other (2019).

NPPES Registry Identity

NPI1912538463

Entity TypeIndividualFemale

Primary Taxonomy363LG0600X

Provider Legal NameTRACY C POOLECredential: NP

Location Address1308 E PAGE AVEMalvern, AR 72104-4518

Mailing Address4196 Highway 62 412 Ste AHardy, AR 72542-8002

Phone(501) 337-9820

Fax(501) 468-0478

Sole ProprietorNo

Medical School CMSOtherGraduated 2019

Enumeration DateFebruary 3, 2020

Last NPPES UpdateDecember 27, 20242 updates tracked since enumeration

NPPES CertifiedDecember 27, 2024

✔ NPI 1912538463 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyNurse Practitioner · GerontologyPhysician Assistants & Advanced Practice Nursing Providers

Taxonomy Code363LG0600X

License✔ Licensed in AR · 123708

1308 E PAGE AVE, Malvern, AR 72104

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Other Names 1

Other Name (5)Tracy C. Bradshaw

Secondary Practice Locations 2

Location 11016 N Fourche AvePerryville, AR 72126-8545 · Phone (501) 237-1284 · Fax (501) 468-0469

Location 21010 N Center StLonoke, AR 72086-2005 · Phone (501) 438-8075 · Fax (501) 468-0452

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Arkansas Blue Cross and Blue Shield, Health Advantage, Octave.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Tracy C Poole Np is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID9638506694

PECOS Enrollment IDI20200304000327

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 72104 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient

$79.72 typical visit price

range $51.36 – $157.74

Typical copayment $19.93 (range $12.84 – $39.43)

Most-billed visit code 99203

Established Patient

$91.63 typical visit price

range $16.16 – $128.77

Typical copayment $22.90 (range $4.04 – $32.19)

Most-billed visit code 99214

Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Other Providers at the Same Location NPPES 11

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

KARA H WILLIAMS APRN

Nurse Practitioner (Family)