Ebonie Myakee Zollicoffer

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

9919 Issued in WI

Practice address

N62W23334 Silver Spring Dr
Sussex, WI 53089-3875

Phone

(262) 225-1163

NPI assigned

Mar 28, 2015

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other names 1

• Ebonie Myakee Carr-Young Former name

Medicare fee-for-service enrollment

Enrolled in WI

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

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: ms_ezollico@landmarkhealth-direct.org

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

• Oak Medical SC

  • Internal Medicine Physician
  • Waukesha, WI
  • NPI 1669910345
  NPD
• Vitae Health Medical Wisconsin LLC

  • Internal Medicine Physician
  • Milwaukee, WI
  • NPI 1508483140
  NPD
• Theoria Medical

  • Internal Medicine Physician
  • Novi, MI
  • NPI 1609362375
  NPD

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

{
    "created_epoch": "1427500800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1788912000000",
    "number": "1376938209",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "N55W21268 LOGAN DR",
            "city": "MENOMONEE FALLS",
            "state": "WI",
            "postal_code": "530516211",
            "telephone_number": "262-225-1163"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "N62W23334 SILVER SPRING DR",
            "city": "SUSSEX",
            "state": "WI",
            "postal_code": "530893875",
            "telephone_number": "262-225-1163"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ZOLLICOFFER",
        "first_name": "EBONIE",
        "middle_name": "MYAKEE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-03-28",
        "last_updated": "2026-09-09",
        "certification_date": "2026-09-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "WI",
            "license": "159473",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "WI",
            "license": "9919",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "EBONIE",
            "last_name": "CARR-YOUNG",
            "middle_name": "MYAKEE",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Kelly Woppert
• Sandra Marie Wucki, RPH
• Megan Yahnke
• Angela Mia Zammuto Markowski, BSN
• Karl Zimmerman

• Family Nurse Practitioner in Sussex, WI
• Providers in Sussex, WI by specialty
• Family Nurse Practitioner in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 9, 2026; 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.

Verify at the official NPI Registry.