Prairie Roots Wellness, LLC
NPI 1467216275ActiveOrganization· Physician Assistant· Mc Cook, NE
Physician Assistant in Mc Cook, Nebraska, registered in NPPES in February 2024. The authorized official on file is Erica Ellicott, PA-C, Physician Assistant. Enrolled in Medicare as part b supplier - clinic/group practice.
Overview
| NPI | 1467216275 |
|---|---|
| Status | Active |
| Entity type | Organization |
| NPI issued | Feb 12, 2024 |
| Last updated in NPPES | Feb 12, 2024 |
| Certified by provider | Feb 12, 2024 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Physician Assistant Primary | 363A00000X | — | — |
Exclusion screening
| List | Result | Details |
|---|---|---|
| HHS-OIG LEIE · Oct 9, 2026 | No match | Checked by NPI and by name + state |
| North Carolina Medicaid · Nov 10, 2026 | No match | — |
| New York OMIG · Nov 10, 2026 | No match | — |
| Ohio Medicaid · Nov 10, 2026 | No match | — |
| Pennsylvania Medicheck · Nov 10, 2026 | No match | — |
| Washington HCA · Nov 10, 2026 | No match | — |
Official OIG search · How matching works ·Bulk check a roster
Medicare
| Enrollment (PECOS) | Enrolled Part B Supplier - Clinic/Group Practice (NE) |
|---|
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