Ellyn Watters, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

2562 Issued in NE

Practice address

1410 N 13TH St
Norfolk, NE 68701-2669

Phone

(402) 360-4343

NPI assigned

Sep 9, 2019

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

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, 2020

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Midwest OB/GYN Clinic, PCGroup PAC ID 9133014764, 14 clinicians

Faith Regional Physician Services LLCGroup PAC ID 5193786168, 194 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Faith Health Hospital, Norfolk, NE, CCN 280125

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 and National Provider Directory roles.

• Faith Regional Physician Services, LLC

  • Family Medicine Physician
  • Norfolk, NE
  • NPI 1265489157
  Medicare reassignment Care Compare group NPD
• Midwest OB/GYN Clinic, PC

  • Family Medicine Physician
  • Norfolk, NE
  • NPI 1538189857
  Medicare reassignment Care Compare group
• Faith Regional Physician Services, LLC

  • Anesthesiology Physician
  • Norfolk, NE
  • NPI 1275074577
  NPD

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

• Faith Regional Health Services

  • General Acute Care Hospital
  • Norfolk, NE
  • NPI 1285676544
  Care Compare affiliation

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

{
    "created_epoch": "1567987200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1682380800000",
    "number": "1932758265",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1410 N 13TH ST",
            "city": "NORFOLK",
            "state": "NE",
            "postal_code": "687012669",
            "telephone_number": "402-371-0123"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1410 N 13TH ST",
            "city": "NORFOLK",
            "state": "NE",
            "postal_code": "687012669",
            "telephone_number": "402-360-4343"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WATTERS",
        "first_name": "ELLYN",
        "credential": "PA-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-09-09",
        "last_updated": "2023-04-25",
        "certification_date": "2023-04-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NE",
            "license": "2562",
            "primary": true
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "IA",
            "license": "1162973",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Lindsey Warsnak
• Lucretia Wasser
• Haley Watson
• Luann Watson
• Sarah Watson
• Devin Watts
• Justin Watts
• Heidi Webb
• Travis Webb
• Amy J Weber, B.S.

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 25, 2023; 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.