Individual provider Active NPI

Elizabeth Ackerson, ARNP

  • Nurse Practitioner
  • Waterloo, IA
National Provider Identifier
1225485097
Registry record updated May 20, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
A126047 Issued in IA
Practice address
3421 W 9TH St
Waterloo, IA 50702-5401
Phone
(319) 272-8000
NPI assigned
May 20, 2016
Last updated
May 20, 2016By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 20, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X A126047 IA Primary

Addresses

Primary practice location

3421 W 9TH St
Waterloo, IA 50702-5401

Mailing address

912 Western Ave
Waterloo, IA 50702-3036
Phone (319) 269-0204

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IA
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
I20160713000307 IA Practitioner - Nurse Practitioner 7911299839 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
A126047IAMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Iowa Emergency Physicians LLP Nurse Practitioner CurrentSince Jul 1, 2016 Accepting new patients
Iowa Emergency Physicians LLP Nurse Practitioner CurrentSince Jul 1, 2016 Accepting new patients

Locations

3421 W 9th St
Waterloo, IA 50702
Phone (319) 272-7050

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1463702400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1463702400000",
    "number": "1225485097",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "912 WESTERN AVE",
            "city": "WATERLOO",
            "state": "IA",
            "postal_code": "507023036",
            "telephone_number": "319-269-0204"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3421 W 9TH ST",
            "city": "WATERLOO",
            "state": "IA",
            "postal_code": "507025401",
            "telephone_number": "319-272-8000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ACKERSON",
        "first_name": "ELIZABETH",
        "credential": "ARNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-05-20",
        "last_updated": "2016-05-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "IA",
            "license": "A126047",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Waterloo, IA

Sources for this page

Verify at the official NPI Registry.