Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
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Tracey S Cloninger, PA-C

Individual provider Physician Assistant · NPI 1164592275

Tracey S Cloninger, PA-C is a Physician Assistant in Raleigh, North Carolina. Graduated from Brody School of Medicine at East Carolina University in 2001, 25 years ago. Practices with Southern Dermatology PA, a 51-clinician group and accepts Medicare assignment. Licensed in North Carolina.

Years since qualifying
25
Trained at
Brody School of Medicine at East Carolina University
Licensed in
NC
In the registry since
2006
What do these letters mean?
PA-C — Physician Assistant, Certified
A physician assistant who holds current national certification.

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Practice location Address checks out

4201 Lake Boone Trl Ste 200
Raleigh, NC 27607-7511
Phone: (919) 782-2152
Fax: (919) 782-7929
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Physician Assistant (primary) Taxonomy 363A00000X · Licence 103242 (NC)

Record details

NPI number1164592275
Entity typeIndividual (Type 1)
GenderFemale
Credentials PA-C
Sole proprietorNo
NPI enumeratedNovember 8, 2006
Last updated in NPPESJune 25, 2026
Certification dateJune 25, 2026

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolBRODY SCHOOL OF MEDICINE AT EAST CAROLINA UNIVERSITY
Graduated 2001 (25 years in practice)
Group practice Southern Dermatology Pa — 51 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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