AMY R ELLINGSON MD PA — NPI 1295907152 (Licensed & Credentialed Allopathic & Osteopathic Physicians — Allergy and Immunology

CMS-1500 Box 24J / 33a • NPI

1295907152

Type 2 Organization (Box 32a/33a)

HIPAA NUCC Taxonomy • CMS Code

207KA0200X (CMS 03)

Licensed & Credentialed Allopathic & Osteopathic Physicians — Allergy and Immunology — Allergy

Box 32 Service Location & ZIP+4

1037 19TH AVE SW, WILLMAR, MN, 56201-5005

✓ 9-Digit EDI 837 ZIP+4 (56201-5005)

Practice Phone & Referral Fax

(320) 214-1100

Fax: (320) 214-1155

✓ HHS OIG LEIE Sanction Screening — VERIFIED CLEAR: NPI 1295907152 (AMY R ELLINGSON MD PA) has 0 active federal exclusions across all 84,224 HHS OIG LEIE sanction records (Database Verified: 2026-11-11).

CMS Medicare Order & Referring PECOS Eligibility

Institutional Type-2 NPI facilities enroll via CMS-855A institutional provider agreements rather than individual Order & Referring PECOS.

Official CMS NPPES Credential & Practice Profile

10-Digit NPI Number	`1295907152` (NPI-2 Organization / Facility)
Provider / Legal Name	AMY R ELLINGSON MD PA
Plain-English Specialty	Licensed & Credentialed Allopathic & Osteopathic Physicians — Allergy and Immunology — Allergy NUCC Code: `207KA0200X` (Allergy & Immunology, Allergy)
Certifying / Licensing Body	State Medical / Healthcare Licensing Board & National Specialty Board
Practice Location Address	1037 19TH AVE SW, WILLMAR, MN, 56201-5005
Practice Telephone / Fax	Tel: (320) 214-1100 \| Fax: (320) 214-1155
Administrative Mailing Address	PO BOX 1015, WILLMAR, MN, 56201-1015
Enumeration & Last Sync	Enumerated: 2008-03-31 \| CMS Record Updated: 2008-03-31
Authorized Official	AMY ELLINGSON (President)

Clinic Location, Accessibility & Directions

📍 Practice Location & Patient Access

1037 19TH AVE SW, WILLMAR, MN, 56201-5005

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Plain-English Taxonomy & CMS Crosswalk (207KA0200X)

What Does Taxonomy Code 207KA0200X Mean?

In the HIPAA National Uniform Claim Committee (NUCC) classification, code 207KA0200X translates to:
"Licensed & Credentialed Allopathic & Osteopathic Physicians — Allergy and Immunology — Allergy"

CMS-1500 Medicare Specialty Crosswalk: CMS Code 03 (Physician/Allergy/ Immunology)
Certifying / Accrediting Authority: State Medical / Healthcare Licensing Board & National Specialty Board
Clinical Scope: Consult a verified Allergy & Immunology, Allergy for specialized diagnostic evaluation, treatment planning, and continuity of care.

Specialty Clinical Procedures & Therapeutic Classes

Standard Scope of Care (AMY R ELLINGSON MD PA)

Typical CPT / Diagnostic Procedures:

Comprehensive Outpatient & Inpatient Clinical Evaluation (CPT 99202–99215)
Diagnostic Workup, Laboratory Ordering & Evidence-Based Care Coordination
Preventive Screening, Patient Counseling & Multidisciplinary Referral

Common Therapeutic Classes:

Evidence-Based Specialty Pharmacotherapy & Preventive Regimens (CMS Part D Standard)

All Registered NUCC Taxonomies & State Licenses

Taxonomy Code & Plain-English Description	State License & Primary Status
`207KA0200X` — Allergy & Immunology, Allergy Plain English: Licensed & Credentialed Allopathic & Osteopathic Physicians — Allergy and Immunology — Allergy	State: MN \| License: `1538` \| Primary: Yes (Primary)

Medical Billing, RCM & Hospital Credentialing Teams:

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AMY R ELLINGSON MD PA (NPI #1295907152)