Individual provider Active NPI

Alicia K Clough, PA-C

  • Physician Assistant
  • Gretna, NE
National Provider Identifier
1083264303
Registry record updated Feb 13, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
2550 Issued in NE
Practice address
720 US-6
Gretna, NE 68028
Phone
(402) 751-0600
NPI assigned
Sep 18, 2019
Last updated
Feb 13, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 13, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 106294 IA
Physician Assistant 363A00000X 2550 NE Primary

Addresses

Primary practice location

720 US-6
Gretna, NE 68028

Mailing address

306 W 2ND St
Hastings, NE 68901-7532

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NE
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230206000827 NE Practitioner - Physician Assistant 8729471396 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
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 LLCGroup PAC ID 7810300282, 7 clinicians
Nemaha County HospitalGroup PAC ID 6204746480, 12 clinicians

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

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Platte River Foot and Ankle Surgeons LLC CurrentSince Feb 20, 2023 Accepting new patients
Chiropractic Essence PLLC PastSince Apr 10, 2023 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

Organizations & group practices 4

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

Hospital & facility affiliations 1

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": "1568764800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1676246400000",
    "number": "1083264303",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "306 W 2ND ST",
            "city": "HASTINGS",
            "state": "NE",
            "postal_code": "689017532"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "720 US-6",
            "city": "GRETNA",
            "state": "NE",
            "postal_code": "68028",
            "telephone_number": "402-751-0600"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CLOUGH",
        "first_name": "ALICIA",
        "middle_name": "K",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-09-18",
        "last_updated": "2023-02-13",
        "certification_date": "2023-02-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "IA",
            "license": "106294",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NE",
            "license": "2550",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Gretna, NE

Sources for this page

Verify at the official NPI Registry.