Ellice Ann Wickwire, R.N.

Primary specialty

Community Health Registered NurseTaxonomy code 163WC1500X

License

041.276442 Issued in IL

Practice address

907 S Main St
Pinckneyville, IL 62274-1700

Phone

(618) 357-5371

Fax

(618) 357-3190

NPI assigned

Jun 3, 2013

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Registered Nurse

State licenses

Practice roles

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.

• Perry County Government

  • Home Health Agency
  • Pinckneyville, IL
  • NPI 1114910312
  NPD (past)
• Perry County Health Department

  • Public Health or Welfare Agency
  • Pinckneyville, IL
  • NPI 1487045423
  NPD (past)

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

{
    "created_epoch": "1370217600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1370217600000",
    "number": "1386081115",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 49",
            "city": "PINCKNEYVILLE",
            "state": "IL",
            "postal_code": "622740049",
            "telephone_number": "618-357-5371",
            "fax_number": "618-357-3190"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "907 S MAIN ST",
            "city": "PINCKNEYVILLE",
            "state": "IL",
            "postal_code": "622741700",
            "telephone_number": "618-357-5371",
            "fax_number": "618-357-3190"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WICKWIRE",
        "first_name": "ELLICE",
        "middle_name": "ANN",
        "credential": "R.N.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-06-03",
        "last_updated": "2013-06-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WC1500X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Community Health",
            "state": "IL",
            "license": "041.276442",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Vna Homecare, Inc.
• Vna Homecare, Inc.
• Lori Reeds Waggoner, MS CCC/SLP
• Ty Lamar Wallace, MSW
• Sharon Lucille White-Findley, D.O.
• Lisa Louise Wild, M.S.E.D, M.S.W.
• Wittenauer Chiropractic PC
• James Albert Wittenauer, D.C.

• Community Health Registered Nurse in Pinckneyville, IL
• Providers in Pinckneyville, IL by specialty
• Community Health Registered Nurse in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 3, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.