NPIMap

Individual provider Active NPI

Heather A Elliott, MSN, NP-C

  • Family Nurse Practitioner
  • Rocky Ford, CO
National Provider Identifier
1003233479
Registry record updated Oct 15, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
APN.0991105-NP Issued in CO
Practice address
1014 Elm Ave
Rocky Ford, CO 81067-1328
Phone
(719) 254-7421
Fax
(719) 254-6966
NPI assigned
Mar 24, 2014
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 15, 2015

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X APN.0991105-NP CO Primary

Addresses

Primary practice location

1014 Elm Ave
Rocky Ford, CO 81067-1328

Mailing address

1014 Elm Ave
P.O. Box 590
Rocky Ford, CO 81067-1328
Phone (719) 254-7421

Other names 1

  • Miss Heather A Lyster Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CO
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20141006000984 CO Practitioner - Nurse Practitioner 3476773987 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Radiant Healthcare LLCGroup PAC ID 6406229038, 5 clinicians
Rocky Ford Family Health Center LLCGroup PAC ID 6002726114, 5 clinicians

Practice addresses (Care Compare)

1014 Elm Ave
Rocky Ford, CO 81067-1328
Phone (719) 254-7421

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science - Nursing, Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Radiant Healthcare LLC Family CurrentSince Jan 1, 2023 Accepting new patients
Ozarks Medical Center Past Accepting new patients

Locations

1014 Elm Ave
Rocky Ford, CO 81067
Phone (719) 254-7421

Interoperability endpoints

  • Direct secure messaging: heather.elliott.1@26604.direct.athenahealth.com

Ownership & related parties

All facility ownership & control disclosures 1

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Radiant Healthcare LLCRocky Ford, CO, CCN 063837 Rural health clinic 5% Or Greater Direct Ownership Interest (100%) Jan 1, 2023

Owned or controlled facilities with NPI records 1

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 12

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1395619200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1444867200000",
    "number": "1003233479",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1014 ELM AVE",
            "address_2": "P.O. BOX 590",
            "city": "ROCKY FORD",
            "state": "CO",
            "postal_code": "810671328",
            "telephone_number": "719-254-7421",
            "fax_number": "719-254-6966"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1014 ELM AVE",
            "city": "ROCKY FORD",
            "state": "CO",
            "postal_code": "810671328",
            "telephone_number": "719-254-7421",
            "fax_number": "719-254-6966"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ELLIOTT",
        "first_name": "HEATHER",
        "middle_name": "A",
        "name_prefix": "Mrs.",
        "credential": "MSN, NP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-03-24",
        "last_updated": "2015-10-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CO",
            "license": "APN.0991105-NP",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "HEATHER",
            "last_name": "LYSTER",
            "middle_name": "A",
            "prefix": "MISS",
            "credential": "NP-C",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Rocky Ford, CO

Sources for this page

Verify at the official NPI Registry.