Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
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Ellie Renee Duckworth, PA-C

Individual provider Physician Assistant · NPI 1356292221

Ellie Renee Duckworth, PA-C is a Physician Assistant in Bolivar, Missouri. Qualified in 2025, 1 year ago. Licensed in Missouri.

Years since qualifying
1
Licensed in
MO
In the registry since
2026
What do these letters mean?
PA-C — Physician Assistant, Certified
A physician assistant who holds current national certification.

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Practice location Address checks out

2230 S Springfield Ave Ste H-J
Bolivar, MO 65613-9133
Phone: (417) 777-4800
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Physician Assistant (primary) Taxonomy 363A00000X · Licence 2026005847 (MO)

Record details

NPI number1356292221
Entity typeIndividual (Type 1)
GenderFemale
Credentials PA-C
Sole proprietorNo
NPI enumeratedFebruary 6, 2026
Last updated in NPPESFebruary 6, 2026
Certification dateFebruary 6, 2026

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 2025 (1 years in practice)
Accepts Medicare assignment Not indicated
Practice locations2 on file with Medicare

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