Ellen Peacock, FNP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

74907 Issued in NM

Practice address

2301 N Dr Martin Luther King Jr Blvd
Clovis, NM 88101-9401

Phone

(575) 762-4455

Fax

(575) 935-5455

NPI assigned

Aug 4, 2023

Last updated

Aug 18, 2026By 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

Medicare fee-for-service enrollment

Enrolled in NM

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

Specialty

Nurse Practitioner

Education

Other, 2023

Medicare assignment

May accept Medicare assignment

Practice addresses (Care Compare)

Hospital & facility affiliations

• Plains Regional Medical Center Hospital, Clovis, NM, CCN 320022

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

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.

• Dynamic Healthcare LLC

  • Family Nurse Practitioner
  • Clovis, NM
  • NPI 1093396160
  Medicare reassignment NPD
• 1 NP Inc

  dba Amarillo Family Healthcare

  • Family Nurse Practitioner
  • Amarillo, TX
  • NPI 1225695737
  NPD (past)
• 1 NP Inc

  dba Farwell Family Healthcare

  • Acute Care Nurse Practitioner
  • Farwell, TX
  • NPI 1295963163
  NPD (past)

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

• Presbyterian Healthcare Services

  dba Plains Regional Medical Center

  • Rural Acute Care Hospital
  • Clovis, NM
  • NPI 1629053509
  Care Compare affiliation

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

{
    "created_epoch": "1691107200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1787011200000",
    "number": "1881376127",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2301 N DR MARTIN LUTHER KING JR BLVD",
            "city": "CLOVIS",
            "state": "NM",
            "postal_code": "881019401",
            "telephone_number": "575-762-4455",
            "fax_number": "575-935-5455"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2301 N DR MARTIN LUTHER KING JR BLVD",
            "city": "CLOVIS",
            "state": "NM",
            "postal_code": "881019401",
            "telephone_number": "575-762-4455",
            "fax_number": "575-935-5455"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PEACOCK",
        "first_name": "ELLEN",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-08-04",
        "last_updated": "2026-08-18",
        "certification_date": "2026-08-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NM",
            "license": "74907",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Shameka Patton
• Samantha Paulison
• Kristine Paulus
• Nola Pawol, PT
• Kelsi Peabody, FNP-C
• Cacianita G Pearson, RN
• Rhyain Pedersen
• Chelsey Lane Pena, RN
• Kathy J Perales, BMS
• Zamary Elizabeth Peredez

• Family Nurse Practitioner in Clovis, NM
• Providers in Clovis, NM by specialty
• Family Nurse Practitioner in New Mexico

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 18, 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.
• 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.