TRACY C POOLE NP
NPI 1912538463
Nurse Practitioner - Gerontology 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 weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 21 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.

Active since February 03, 2020PECOS Enrolled

1308 E PAGE AVE, MALVERN, AR 72104(501) 337-9820(501) 468-0478 Get Directions Write a Review

NPPES record last updated: December 27, 2024. Verified against the NPPES registry weekly; last sync: October 18, 2026.

Record update history: Dec 27, 2024, Feb 3, 2020 (2 updates tracked since 2020).

On this page

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 and maintains 2 additional practice locations.

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

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 11010 N Center StLonoke, AR 72086-2005 · Phone (501) 438-8075 · Fax (501) 468-0452

Location 21016 N Fourche AvePerryville, AR 72126-8545 · Phone (501) 237-1284 · Fax (501) 468-0469

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, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Tracy C Poole Np is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

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.

Medicare Billing Reassignments

Medicare enrollment records show Tracy Poole reassigns Medicare billing to 3 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.

Access Medical Clinic Arkansas Ltc LLC

Same address

Rural Health

1308 E PAGE AVE
Malvern, AR 72104

Reassigned Medicare billing, Arkansas enrollment
117 clinicians in this Medicare group

NPI 1639702731 (501) 337-9820

Curana Health Of Arkansas LLC

159 mi

Nurse Practitioner

609 SW 8TH ST
Bentonville, AR 72712

Reassigned Medicare billing, Arkansas enrollment
60 clinicians in this Medicare group

NPI 1659750214 (337) 991-9276

Daiya Healthcare PLLC

1,773 mi

Internal Medicine

11120 NE 33RD PL STE 202
Bellevue, WA 98004

Reassigned Medicare billing, Arkansas enrollment
7 clinicians in this Medicare group

NPI 1477027381 (206) 823-1004

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

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 10

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

HALEY BETH HOBSON PA-C

Physician Assistant