Erica Leigh Ellicott, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

1908 Issued in NE

Practice address

801 W C St
MC Cook, NE 69001-3591

Phone

(308) 777-2476

Fax

(308) 223-5752

NPI assigned

Mar 16, 2015

Last updated

Feb 12, 2024By 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

Electronic endpoints 1

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

Specialty

Physician Assistant

Education

Other, 2014

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Hospital & facility affiliations

• The Nebraska Medical Center Hospital, Omaha, NE, CCN 280013

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

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.

• Prairie Roots Wellness, LLC

  • Physician Assistant
  • McCook, NE
  • NPI 1467216275
  Medicare reassignment Authorized official
• Banner Health Physicians West LLC

  • Multi-Specialty Clinic/Center
  • Ogallala, NE
  • NPI 1154687812
  Medicare reassignment NPD
• Ogallala Community Hospital

  • Critical Access Hospital
  • Ogallala, NE
  • NPI 1710915467
  Medicare reassignment
• Ogallala Community Hospital

  dba Banner Health Clinic

  • Rural Health Clinic/Center
  • Ogallala, NE
  • NPI 1396455481
  NPD
• Banner Health Physicians Colorado LLC

  • Multi-Specialty Clinic/Center
  • Windsor, CO
  • NPI 1831476381
  NPD (past)

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

• The Nebraska Medical Center

  dba The Nebraska Medical Center - Nebraska Medicine

  • General Acute Care Hospital
  • Omaha, NE
  • NPI 1356307581
  Care Compare affiliation

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

{
    "created_epoch": "1426464000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1707696000000",
    "number": "1902299860",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "136 W 12TH ST",
            "city": "IMPERIAL",
            "state": "NE",
            "postal_code": "690333112",
            "telephone_number": "308-883-0658"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "801 W C ST",
            "city": "MC COOK",
            "state": "NE",
            "postal_code": "690013591",
            "telephone_number": "308-777-2476",
            "fax_number": "308-223-5752"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2601 N Spruce St",
            "address_purpose": "LOCATION",
            "city": "Ogallala",
            "state": "NE",
            "postal_code": "691532465",
            "country_code": "US",
            "telephone_number": "308-284-4011",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ELLICOTT",
        "first_name": "ERICA",
        "middle_name": "LEIGH",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-03-16",
        "last_updated": "2024-02-12",
        "certification_date": "2024-02-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NE",
            "license": "1908",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "erica.ellicott@bannerhealth.com",
            "affiliation": "N",
            "endpointDescription": "work email",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "2601 N Spruce St",
            "city": "Ogallala",
            "state": "NE",
            "country_code": "US",
            "postal_code": "691532465",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Angela S Ebert
• Destiney Ebert
• Jessie Elizabeth Ebert
• Kaylee Eckert
• Elevate Wellness, LLC
• Ellington Eyecare PLLC
• Ashley Elliott
• Emeritus Corporation (Brookdale McCook)
• Shayla Emory
• Taylor Erickson

• Physician Assistant in McCook, NE
• Providers in McCook, NE by specialty
• Physician Assistant in Nebraska

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 12, 2024; 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.