TRACI C BOULLION (AGNP-C) – Hospitalist Physician, NPI 1568096279
Hospitalist Physician
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
9,658 NURSE PRACTITIONER in GA
Provider Addresses for TRACI C BOULLION (AGNP-C)
127 SANTOLINA PARK
PEACHTREE CITY, GA 302693245
Phone: (256) 438-9828
Type: Mailing
311 N CLYDE MORRIS BLVD
DAYTONA BEACH, FL 321142781
Phone: (386) 241-1020
Fax: (386) 241-1022
Type: Mailing
55 Whitcher St NE Ste 130
Marietta, GA 300601156
Phone: (770) 428-0462
Fax: (770) 427-8001
Type: Location
127 Santolina Park
Peachtree City, GA 302693245
Phone: (564) 389-8282
Type: Location
55 WHITCHER ST NE STE 130
MARIETTA, GA 300601156
Phone: (770) 428-0462
Fax: (770) 427-8001
Type: Mailing
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
CMS reports 2 Open Payments records for all available years, with a total value of $174.
Total Amount is formed as General ($174) + Research ($0) + Ownership ($0) = $174.
Last reported payment date: 2024-04-24 • Largest payer in this snapshot: Kerecis Limited ($142).
Total Amount
$174
General + Research + Ownership
Payments
2
Total payment records
General Amount
$174
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2024-04-24
Latest reported date
Top Companies
Largest payers in this snapshot
| Company | Amount |
|---|---|
| Kerecis Limited | $142 |
| LifeNet Health | $32 |
Medicare Enrollment & Revalidation
Source: CMS public data · Not endorsed by CMS ·
Educational use only—not medical, billing, or legal advice.
PECOS enrollment status
Participating (accepts Medicare assignment)
Enrollment effective: 2024-12-05
PECOS data refreshed: 2026-06-15
Medicare revalidation (CMS due date list)
Due date not assigned yet
CMS is tracking 2 Medicare enrollment records; no due dates published yet.
Enrollment records
2
Earliest due date
Not assigned (TBD)
CMS data updated
2026-06-01
Revalidation progress
- Medicare enrolled
- On CMS revalidation list
- Due date assigned
- Revalidate in PECOS
CMS enrollment records
| Enrollment ID | Type | Specialty | State | Due date |
|---|---|---|---|---|
| I20210405001254 | I | Nurse Practitioner | GA | TBD |
| I20241205004247 | I | Nurse Practitioner | FL | TBD |
What to do next
- No action required while the due date shows TBD.
- Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
- Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.
Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS
Medicare Utilization (FFS)
Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·
Educational use only—not medical, billing, or legal advice.
No Medicare fee-for-service utilization data available for this provider in our database.
Insurance plans in this area (ZIP 30269)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| Anesthesiology, Pain Management | FL | |
| Nurse Practitioner | FL | |
| G A S T R O E N T E R O L O G Y | FL | |
| - | FL | |
| Nurse Practitioner | FL | |
| - | FL | |
| - | FL | |
| - | FL | |
| - | FL | |
| - | FL |
Reviews
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