MRS. TRACIE THERESA EDWARDS NP NPI 1104486711

NPI Information

  • NPI: 1104486711
  • Provider Name: MRS. TRACIE THERESA EDWARDS, NP
  • Classification: Nurse Practitioner - 363L00000X
  • Entity Type: Individual
  • PECOS Registration: Yes
  • Address: 1412 MILSTEAD AVE NE
    CONYERS, GA
    ZIP 30012
  • Phone: (770) 918-3000

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NPI Details

MRS. Tracie Theresa Edwards, NP is a nurse practitioner in Conyers, GA with 6 years of experience. The provider is (1) A registered nurse provider with a graduate degree in nursing prepared for advanced practice involving independent and interdependent decision making and direct accountability for clinical judgment across the health care continuum or in a certified specialty. (2) A registered nurse who has completed additional training beyond basic nursing education and who provides primary health care services in accordance with state nurse practice laws or statutes. Tasks performed by nurse practitioners vary with practice requirements mandated by geographic, political, economic, and social factors. Nurse practitioner specialists include, but are not limited to, family nurse practitioners, gerontological nurse practitioners, pediatric nurse practitioners, obstetric-gynecologic nurse practitioners, and school nurse practitioners. MRS. Tracie Theresa Edwards, NP NPI is 1104486711. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

The provider's business location address is:

1412 MILSTEAD AVE NE
CONYERS, GA
ZIP 30012-877
Phone: (770) 918-3000
Fax: (770) 918-3104

The NPI 1104486711 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The following top HCPCS codes were publicly reported for this provider under the Medicare program for the year 2016. The reported codes are based on the top codes for each available Medicare specialty, excluding evaluation and management codes.

  • Critical care, first 30-74 minutes (HCPCS:99291)
  • Critical care, each additional 30 minutes (HCPCS:99292)
  • Follow-up hospital inpatient care per day, typically 35 minutes (HCPCS:99233)

The enumeration date for this NPI number is 6/17/2019 and was last updated on 11/1/2019.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1363L00000XNurse PractitionerRN288766GEORGIAYes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 3/30/2025

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