Jerry G Elliott, NP-C

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

AP60240764 Issued in WA

Practice address

888 Swift Blvd
Richland, WA 99352

Phone

(509) 946-9611

Fax

(509) 942-2185

NPI assigned

May 27, 2009

Last updated

Nov 8, 2016By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 3

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in WA, OR, ID3 enrollments

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 3

Specialty

Nurse Practitioner

Education

Other, 2009

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

RCCH Trios Health LLCGroup PAC ID 5799035416, 65 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Trios Health Hospital, Kennewick, WA, CCN 500053

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: jelliott2848386@direct.trinity-health.org

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.

• RCCH Trios Health LLC

  • Internal Medicine Physician
  • Kennewick, WA
  • NPI 1831682806
  Medicare reassignment Care Compare group NPD
• Good Shepherd Health Care System

  dba Good Shepherd Medical Center

  • Critical Access Hospital
  • Hermiston, OR
  • NPI 1295789667
  Medicare reassignment NPD
• Sound Physicians of Idaho

  dba Sound Physicians

  • Hospitalist Physician
  • Lewiston, ID
  • NPI 1730407461

  Nurse Practitioner

  Medicare reassignment NPD
• Northwest Hospital Medicine Physicians LLC

  • Hospitalist Physician
  • Las Cruces, NM
  • NPI 1972056752

  WA

  Medicare reassignment
• Good Shepherd Health Care System

  dba Good Shepherd Medical Group

  • Pediatrics Physician
  • Hermiston, OR
  • NPI 1336198159
  NPD
• Kennewick Public Hospital District

  dba KGH Physician Clinics

  • Multi-Specialty Clinic/Center
  • Kennewick, WA
  • NPI 1235257262
  NPD (past)

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

• RCCH Trios Health LLC

  • General Acute Care Hospital
  • Kennewick, WA
  • NPI 1578058137
  Care Compare affiliation

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

{
    "created_epoch": "1243382400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1478563200000",
    "number": "1114152758",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "560 GAGE BLVD",
            "address_2": "SUITE 203",
            "city": "RICHLAND",
            "state": "WA",
            "postal_code": "99352",
            "telephone_number": "509-942-3627",
            "fax_number": "509-942-2268"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "888 SWIFT BLVD",
            "city": "RICHLAND",
            "state": "WA",
            "postal_code": "99352",
            "telephone_number": "509-946-9611",
            "fax_number": "509-942-2185"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ELLIOTT",
        "first_name": "JERRY",
        "middle_name": "G",
        "credential": "NP-C",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2009-05-27",
        "last_updated": "2016-11-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "ID",
            "license": "N-35393",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "ID",
            "license": "NP-917A",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "WA",
            "license": "AP60240764",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "002803300",
            "state": "ID"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Eli Thornock DDS PLLC (Richland Dental Center)
• Carling Eliason, L.M.P.
• Elise Nelson Licsw LLC
• Cidnee Ellingsworth, RDH
• Daniel R. Elliott, PA-C
• Dana Michelle Ellis
• Melissa Ellison, LMHC
• Kimberly D. Elmore, CNM
• Embrace Change Counseling
• Emeritus Corporation (Brookdale Torbett)

• Nurse Practitioner in Richland, WA
• Providers in Richland, WA by specialty
• Nurse Practitioner in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 8, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.