MRS. TRACY LYNN VERCILLO (NPI# 1679031710) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1679031710 |
| Entity Type | Individual |
| Full Name | MRS. TRACY LYNN VERCILLO |
| Credential | RN |
| Practice Address |
229 S Davis Rd Ste 900 Lagrange GA 30241-2609 |
| Mailing Address |
1140 Pyne Rd Lagrange GA 30240-6624 |
| Practice Telephone | 7067561489 |
| Mailing Telephone | 2059136567 |
| Enumeration Date | 2019-03-07 |
| Last Update Date | 2019-03-07 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 163WA0400X |
Registered Nurse Specialization: Addiction (Substance Use Disorder) |
RN085566 | GA | Nursing Service Providers |
| Street Address |
229 S DAVIS RD STE 900 |
| City | LAGRANGE |
| State | GA |
| Zip Code | 30241-2609 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1861905622 | Linda Mersch | Counselor | 229 S Davis Rd Ste 900, Lagrange, GA 30241-2609 | 2017-11-14 |
| 1740887389 | Kyle Abernathy | Counselor | 229 S Davis Rd Ste 900, Lagrange, GA 30241-2609 | 2020-10-07 |
| 1881151769 | Katherine Amanda Parks | Counselor | 229 S Davis Rd Ste 900, Lagrange, GA 30241-2609 | 2019-02-27 |
| 1437646064 | Konrad Deiss | Counselor | 229 S Davis Rd Ste 900, Lagrange, GA 30241-2609 | 2018-04-19 |
| 1194212274 | Jill Garcia | Licensed Practical Nurse | 229 S Davis Rd Ste 900, Lagrange, GA 30241-2609 | 2018-04-16 |
| 1720575814 | Sheila Mayfield | Registered Nurse | 229 S Davis Rd Ste 900, Lagrange, GA 30241-2609 | 2018-04-16 |
| 1376030437 | Jessica Castellanos | Licensed Practical Nurse | 229 S Davis Rd Ste 900, Lagrange, GA 30241-2609 | 2018-04-15 |
| 1386131449 | Tameka Stinson | Licensed Practical Nurse | 229 S Davis Rd Ste 900, Lagrange, GA 30241-2609 | 2018-04-15 |
| 1629565817 | Lewis Powell | Pharmacist | 229 S Davis Rd Ste 900, Lagrange, GA 30241-2609 | 2018-04-13 |
| 1760979942 | Saysha Buchanan | Counselor | 229 S Davis Rd Ste 900, Lagrange, GA 30241-2609 | 2018-04-13 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1073994182 | Pathways Center for Behavioral and Developmental Growth | Community/Behavioral Health | 102 Corporate Park Drive East, Lagrange, GA 30241 | 2015-06-15 |
| 1235303686 | Atlas Neck & Back Center | Chiropractor | 309 N. Morgan St., Suite A, Lagrange, GA 30241 | 2008-04-16 |
| 1578756565 | Richard Freeman Simmons | Dentist | 2219 B West Point Rd, Dr Richard F Simmons, Lagrange, GA 30241 | 2007-08-22 |
| 1013071851 | Troup County School District | Local Education Agency (LEA) | 100 North Davis Road, Lagrange, GA 30241 | 2006-12-19 |
| 1851748172 | Medventures Physical Therapy, LLC | Physical Therapist | 1075 Lafayette Parkway, Ste 220, Lagrange, GA 30241 | 2016-05-17 |
| 1154784205 | Med Ventures Mri, LLC | Radiology | 1075 Lafayette Parkway, Ste 120, Lagrange, GA 30241 | 2016-04-05 |
| 1437514965 | Holly Renee Abbott | Counselor | 104 Harwell Ave, Lagrange, GA 30241 | 2015-12-29 |
| 1386780104 | Andre D Feria Md | Internal Medicine | 142 Old Mill Road, Lagrange, GA 30241 | 2007-01-29 |
| 1356354500 | Mohd Khairul Anam | Internal Medicine | 142 Old Mill Road, Lagrange, GA 30241 | 2006-08-15 |
| 1417914052 | Troup County Health Department | Public Health or Welfare | 1220 Hogansville Rd, Department of Family and Childrens Services Health Cent, Lagrange, GA 30241 | 2006-04-27 |
| Find all providers in zip 30241 | ||||
| Taxonomy Code | 163WA0400X |
| Grouping | Nursing Service Providers |
| Classification | Registered Nurse |
| Specialization | Addiction (Substance Use Disorder) |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1720626963 | Patti Mckinley Prater | Registered Nurse | 37 Calumet Pkwy Ste 101, Newnan, GA 30263-6734 | 2019-12-18 |
| 1851932156 | Nancy Ann Ivie | Registered Nurse | 4271 S Lee St Ste 101, Buford, GA 30518-3710 | 2019-10-08 |
| 1164994901 | Gwendolyn Jordan Taylor | Registered Nurse | 940-c Ga Hwy 96, Same, Warner Robins, GA 31088 | 2018-12-18 |
| 1346734217 | Ella Michelle Stephenson | Registered Nurse | 7002 Annie Walk, Lithonia, GA 30038-4675 | 2018-06-14 |
| 1689182685 | Candace Annette Thompson | Registered Nurse | 4751 Best Rd Ste 150, Atlanta, GA 30337-5601 | 2018-01-12 |
| 1093251167 | Emily Ann Brumfield | Registered Nurse | 2109 Fairburn Rd, Ste A, Douglasville, GA 30135-1037 | 2017-01-13 |
| 1275080541 | Brenda Goodgame | Registered Nurse | 109 Austin Way, 109 Austin Way, Savannah, GA 31419-6207 | 2016-09-05 |
| 1437425899 | Shasheeta Youlanda Hammond | Registered Nurse | 1300 Georgian Pl Apt 5, Dalton, GA 30720-4388 | 2012-03-29 |
| 1679804603 | County Paradise Assisted Living | Registered Nurse | 546 Macon Road, Mcintyre, GA 31054 | 2010-01-14 |
| 1275775801 | Cynthia Ann Frissora Murray | Registered Nurse | 6563 Garrett Rd, Buford, GA 30518-1109 | 2009-03-27 |
| Find all providers with the same taxonomy | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.