Individual provider Active NPI

Erin N Stickney, APRN

  • Nurse Practitioner
  • Kearney, NE
National Provider Identifier
1861775421
Registry record updated Jan 5, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
111303 Issued in NE
Practice address
4715 2ND Ave
Kearney, NE 68847-2463
Phone
(308) 455-1500
Fax
(308) 455-1502
NPI assigned
Sep 21, 2011
Last updated
Jan 5, 2021By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 5, 2021

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 111303 NE Primary

Addresses

Primary practice location

4715 2ND Ave
Kearney, NE 68847-2463

Mailing address

2401 E Ave Unit 3077
Kearney, NE 68848-0347
Phone (308) 455-1500

Other practice location 1

3219 Central Ave
Suite 107
Kearney, NE 68847-2949
Phone (308) 865-2601

Other identifiers 1

IdentifierTypeStateIssuer
1952661654MedicaidNE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NE
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
I20111010000394 NE Practitioner - Nurse Practitioner 0941472229 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Creighton University School of Medicine, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Elite Health and Wellness LLCGroup PAC ID 3971918715, 2 clinicians

Practice addresses (Care Compare)

4715 2ND Ave
Kearney, NE 68847-2463
Phone (308) 455-1500

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Elite Health and Wellness LLC Nurse Practitioner CurrentSince Jan 1, 2021 Accepting new patients
Mid America Neurosurgery Clinic PC Past Accepting new patients
Central Nebraska Cardiology Past Accepting new patients

Locations

2401 E Ave
Unit 3077
Kearney, NE 68848

4715 2nd Ave
Kearney, NE 68847
Phone (308) 455-1500

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.

Hospital & facility affiliations 3

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1316563200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1609804800000",
    "number": "1861775421",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2401 E AVE UNIT 3077",
            "city": "KEARNEY",
            "state": "NE",
            "postal_code": "688480347",
            "telephone_number": "308-455-1500",
            "fax_number": "308-455-1502"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4715 2ND AVE",
            "city": "KEARNEY",
            "state": "NE",
            "postal_code": "688472463",
            "telephone_number": "308-455-1500",
            "fax_number": "308-455-1502"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3219 Central Ave",
            "address_2": "Suite 107",
            "address_purpose": "LOCATION",
            "city": "Kearney",
            "state": "NE",
            "postal_code": "688472949",
            "country_code": "US",
            "telephone_number": "308-865-2601",
            "fax_number": "308-865-2829",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "STICKNEY",
        "first_name": "ERIN",
        "middle_name": "N",
        "name_prefix": "Ms.",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-09-21",
        "last_updated": "2021-01-05",
        "certification_date": "2021-01-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "NE",
            "license": "111303",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1952661654",
            "state": "NE"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Kearney, NE

Sources for this page

Verify at the official NPI Registry.