Alicia K Clough, PA-C
Individual provider Active NPI Physician Assistant · Gretna, NE
NPI 1083264303 · NPPES record last updated Feb 13, 2023
Key facts
- NPI
- 1083264303
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Physician Assistant 363A00000X
- License
- 2550 (NE)
- Practice address
- 720 US-6
Gretna, NE 68028 - Phone
- (402) 751-0600
- NPI assigned
- Sep 18, 2019
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 6
Hospital & facility affiliations 1
Medicare Care Compare profile
- Specialty
- Physician Assistant
- Education
- Other, 2019
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Platte River Foot and Ankle Surgeons LLC
Nemaha County Hospital
Practice addresses (Care Compare)
11334 Elm St
Omaha, NE 68144-4733
Phone (402) 751-0600
2022 13TH St
Auburn, NE 68305-1701
Phone (402) 751-0600
2022 13TH St
Auburn, NE 68305-1799
2710 S St
Lincoln, NE 68502-3252
Phone (402) 751-0600
306 W 2ND St
Hastings, NE 68901-7532
Phone (402) 751-0600
720
Suite 6
Gretna, NE 68028-7943
Phone (402) 751-0600
Hospital & facility affiliations
- Nemaha County Hospital
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in NE
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20230206000827 | NE | Practitioner - Physician Assistant | 8729471396 | Reassigns benefits to 2 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2550 | NE | MD | Speech-Language Pathologist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Platte River Foot and Ankle Surgeons LLC | Current |
Accepting new patients | |
| Chiropractic Essence PLLC | Past |
Accepting new patients |
Locations
2022 13th St
Auburn, NE 68305
Phone (402) 274-4366
720 Us6
Gretna, NE 68028
Phone (402) 463-1355
306 W 2nd St
Hastings, NE 68901
Phone (402) 463-1355
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | 106294 | IA | |
| Physician Assistant | 363A00000X | 2550 | NE | Yes |
Addresses
Primary practice location
720 US-6
Gretna, NE 68028
Mailing address
306 W 2ND St
Hastings, NE 68901-7532
Other providers in Gretna, NE
- Taylor A Cech
- Cheryl Marie Chapman
- City of Gretna
- Brenna Clarke
- Ella Clarke
- Patrick J Cockerill
- Ann Colgrove
- Anthony Dean Colgrove
- Community Pharmacy Services LLC
- Addyson Connolly
All providers in Gretna, NE · Physician Assistant in Nebraska
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Feb 13, 2023. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.