Active NPI
Elizabeth Ann Elliott
- Nurse Practitioner
- Saint Cloud, MN
National Provider Identifier
1225677057
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Nurse Practitioner
- License
- 7602
- Practice address
- 1406 6TH Ave N
Saint Cloud, MN 56303-1900 - Phone
- (320) 251-3700
- NPI assigned
- Dec 26, 2019
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Nurse Practitioner | 363L00000X | 7602 | MN | Primary |
Addresses
Primary practice location
1406 6TH Ave N
Saint Cloud, MN 56303-1900
Mailing address
1406 6TH Ave N
Saint Cloud, MN 56303-1900
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in MN
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: No
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20200214001148 | MN | Practitioner - Nurse Practitioner | 3779919535 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 7602 | MN | MD | Speech-Language Pathologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1577318400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1577318400000",
"number": "1225677057",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1406 6TH AVE N",
"city": "SAINT CLOUD",
"state": "MN",
"postal_code": "563031900"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1406 6TH AVE N",
"city": "SAINT CLOUD",
"state": "MN",
"postal_code": "563031900",
"telephone_number": "320-251-3700"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ELLIOTT",
"first_name": "ELIZABETH",
"middle_name": "ANN",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2019-12-26",
"last_updated": "2019-12-26",
"certification_date": "2019-12-26",
"status": "A"
},
"taxonomies": [
{
"code": "363L00000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner",
"state": "MN",
"license": "7602",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Saint Cloud, MN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 26, 2019; 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.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.