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Tracy Lynn Petersen

Case Manager/Care Coordinator β€’ Moline, IL

Active NPI 1639785454 Individual Practitioner Female Practitioner
Practice location in NPPES

4600 3rd St
Moline, IL 612656106

Call 3097793000 Location details and other listings
Medical Disclaimer

This profile restates public CMS/NPPES data; T-MedInfo gives no medical advice — consult a licensed professional, and call 911 for emergencies.

Practice Location & Contact Primary Location

Practice Address

4600 3rd St

Moline, IL 612656106

Telephone 3097793000
Organization at the Same NPPES Address or Phone
Trinity Medical Center Facility NPI 1528225760

Matched by practice address or phone in NPPES. A shared address or phone does not confirm that this clinician works there.

NPI first issued

2020

The year this clinician's National Provider Identifier (NPI) was issued. An NPI is a unique 10-digit ID that US health care providers use for billing.

What this does not show: NPI first issued

NPIs have been issued only since 2005, so this year is not necessarily when the clinician started practicing.

Source: CMS NPPES NPI Registry.

Medicare assignment not listed

CMS data do not show whether this clinician accepts Medicare assignment. This does not mean they do not accept Medicare. Ask the office.

Medicare assignment applies to Original Medicare. It does not tell you whether the clinician is in a Medicare Advantage plan's network, accepts other insurance, or is taking new patients.

Source: CMS Doctors and Clinicians; Medicare.gov, β€œDoes your provider accept Medicare as full payment?”

Guide: What Medicare assignment means

No telehealth indicator

CMS shows this indicator only when recent Medicare claims include telehealth services. The clinician may still offer telehealth; ask the office.

Source: CMS, Telehealth Indicator on Medicare Care Compare (fact sheet, January 2023); CMS Doctors and Clinicians.

Guide: How Medicare covers telehealth

Compared with the same specialty in Moline and Illinois

9 active clinicians are listed under Case Manager/Care Coordinator with a practice address in Moline, IL (1,123 in Illinois).

Addresses are self-reported to NPPES and may be out of date.

Sources: CMS Doctors and Clinicians, CMS NPPES NPI Registry. Specialty names follow the NUCC Health Care Provider Taxonomy.

Text: T-MedInfo Β· Report an error.

Specialties & License Numbers Reported to NPPES

Self-certified to NPPES: 2020-10-20
Case Manager/Care Coordinator Primary Specialty

NUCC Taxonomy Code: 171M00000X

A person who provides case management services and assists an individual in gaining access to needed medical, social, educational, and/or other services. The person has the ability to provide an assessment and review of completed plan of care on a periodic basis. This person is also able to take collaborative action to coordinate the services with other providers and monitor the enrollee's progress toward the cost-effective achievement of objectives specified in the plan of care. Credentials may vary from an experience in the fields of psychology, social work, rehabilitation, nursing or a closely related human service field, to a related Assoc of Arts Degree or to nursing credentials. Some states may require certification in case management.

Check License Status with the State Board License numbers are self-reported to NPPES; T-MedInfo does not confirm them against state records. Current status: Illinois Department of Financial and Professional Regulation.
Look Up on State Board Site

Clinicians Sharing This Practice Address or Phone

Clinicians sharing this NPPES address, phone or fax; a shared contact does not mean they work together.

2 listed
Treena Adams , APN

Nurse Practitioner - Family

NPI 1114394491

Advanced Practice Nurse

Marcey Millage , PMHNP

Nurse Practitioner - Psychiatric/Mental Health

NPI 1316677339

Psychiatric-Mental Health Nurse Practitioner

Career & Practice History Timeline

Changes recorded in monthly NPPES data files: addresses, names, credentials, specialties and NPI status

8 Historical Events
πŸ“
Updated Business Mailing Address October 20, 2020

Registered at 2200 3RD AVE, ROCK ISLAND, IL 612018840 (Tel: 3097792094)

πŸŽ“
Medical Taxonomy / Specialty Registered (Primary Specialty) October 20, 2020

Case Manager/Care Coordinator

βœ…
NPI Profile Active September 17, 2020

NPI status registered as active in NPPES database

πŸ“
Practice Location (Initial Record) September 17, 2020

Registered at 4600 3RD ST, MOLINE, IL 612656106 (Tel: 3097793000)

πŸ“
Business Mailing Address (Initial Record) September 17, 2020

Registered at 2701 17TH ST, ROCK ISLAND, IL 612015351 (Tel: 3097792031)

πŸ‘€
Provider Name / Credentials (Initial Record) September 17, 2020

Recorded as TRACY PETERSEN

πŸŽ“
Medical Taxonomy / Specialty Registered (Primary Specialty) September 17, 2020

Counselor

🟒
Initial NPI Registration & Enumeration September 17, 2020

First registered as active Individual Practitioner in NPPES Database.

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NPI Administrative Meta

NPI Number: 1639785454
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: September 17, 2020
Last Update: October 20, 2020
Sole Proprietor: No

Mailing Address

2200 3rd Ave

Rock Island, IL 612018840

Phone: 3097792094

About This Data NPPES fields (address, phone, specialty, license) are self-reported and may be outdated; Medicare fields follow the CMS dataset named in each section. Correct directly at NPPES.