Traci Lynnette Ellis, APRN

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

111534 Issued in NE

Practice address

1313 S St Ste a
Bridgeport, NE 69336-2563

Phone

(308) 262-1755

Fax

(308) 262-0765

NPI assigned

Dec 10, 2013

Last updated

May 12, 2020By the provider in NPPES

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

Other names 1

• Traci Lynnette Ellis Other name

Medicare fee-for-service enrollment

Enrolled in KS, NE, TX3 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, 2013

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Harlan Medical LLCGroup PAC ID 8628206034, 11 clinicians

VWB LLCGroup PAC ID 7113349895, 9 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: traci.ellis@nehiidirectmail.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.

• Harlan Medical, LLC

  dba Bellevue Urgent Care

  • Urgent Care Clinic/Center
  • Bellevue, NE
  • NPI 1487089611
  Medicare reassignment Care Compare group NPD
• VWB LLC

  dba AFC Urgent Care

  • Urgent Care Clinic/Center
  • Omaha, NE
  • NPI 1154943835
  Medicare reassignment Care Compare group NPD
• 4G Enterprises, LLC

  dba Rockbrook Urgent Care

  • Urgent Care Clinic/Center
  • Omaha, NE
  • NPI 1033544267
  Medicare reassignment NPD
• Hydr8, LLC

  dba West Omaha Urgent Care

  • Urgent Care Clinic/Center
  • Omaha, NE
  • NPI 1922735406
  Medicare reassignment NPD
• Make Medical, LLC

  dba Urgent Care Network Crossroads

  • Urgent Care Clinic/Center
  • Omaha, NE
  • NPI 1295181022
  Medicare reassignment NPD
• Urgent Care Bennington, LLC

  dba Bennington Urgent Care

  • Urgent Care Clinic/Center
  • Bennington, NE
  • NPI 1033940879
  Medicare reassignment NPD
• Eagle Butte Indian Health Service Hospital

  • Public Health or Welfare Agency
  • Eagle Butte, SD
  • NPI 1558395848

  TX

  Medicare reassignment NPD
• Hamilton County Hospital

  • Critical Access Hospital
  • Syracuse, KS
  • NPI 1932136074
  Medicare reassignment NPD
• Bellevue Urgent Care LP

  • Urgent Care Clinic/Center
  • Bellevue, NE
  • NPI 1861632127
  NPD
• Premier Urgent Care/Family Care of Nebraska LLC

  • Urgent Care Clinic/Center
  • Omaha, NE
  • NPI 1619354511
  NPD
• Midwest Minor Medical PC

  • Urgent Care Clinic/Center
  • Omaha, NE
  • NPI 1770677601
  NPD (past)
• Muc-Papillion LLC

  dba Midlands Family Urgent Care

  • Urgent Care Clinic/Center
  • Papillion, NE
  • NPI 1841159944
  NPD (past)

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

{
    "created_epoch": "1386633600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1589241600000",
    "number": "1801227368",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1313 S ST STE A",
            "city": "BRIDGEPORT",
            "state": "NE",
            "postal_code": "693362563",
            "telephone_number": "308-262-1755",
            "fax_number": "308-262-0765"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1313 S ST STE A",
            "city": "BRIDGEPORT",
            "state": "NE",
            "postal_code": "693362563",
            "telephone_number": "308-262-1755",
            "fax_number": "308-262-0765"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3911 Avenue B",
            "address_2": "Suite 1100",
            "address_purpose": "LOCATION",
            "city": "Scottsbluff",
            "state": "NE",
            "postal_code": "693614617",
            "country_code": "US",
            "telephone_number": "308-630-2100",
            "fax_number": "308-630-2113",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ELLIS",
        "first_name": "TRACI",
        "middle_name": "LYNNETTE",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-12-10",
        "last_updated": "2020-05-12",
        "certification_date": "2020-05-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NE",
            "license": "111534",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "TRACI",
            "last_name": "ELLIS",
            "middle_name": "LYNNETTE",
            "credential": "FNP-C",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Megan Cline
• Cherry L Cooper, APRN
• Amy Dawn Craig, LPN
• Melony Detweiler
• Laura L Douthit, PTA
• Alexia Garcia
• Diane E. Gilles, M.D.
• Courtney Gregory
• Denyse M Grimes-Woolbright
• Douglas L. Hadden, PA-C

• Family Nurse Practitioner in Bridgeport, NE
• Providers in Bridgeport, NE by specialty
• Family Nurse Practitioner in Nebraska

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 12, 2020; 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.