NPIMap

Individual provider Active NPI

Sean C. Erickson, MD

  • Family Medicine Physician
  • Blair, NE
National Provider Identifier
1023677176
Registry record updated Sep 11, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
33115 Issued in NE
Practice address
812 N 22ND St
Blair, NE 68008-1128
Phone
(402) 426-4611
Fax
(402) 426-4642
NPI assigned
Jun 12, 2019
Last updated
Sep 11, 2023By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 11, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 33115 NE Primary

Addresses

Primary practice location

812 N 22ND St
Blair, NE 68008-1128

Mailing address

812 N 22ND St
Blair, NE 68008-1128
Phone (402) 426-4611

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NE
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20211210001189 NE Practitioner - Family Practice 2365772225 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

812 N 22ND St
Blair, NE 68008-1128
Phone (402) 426-4611

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Colonoscopy1-10
Upper gastrointestinal (GI) endoscopy for acid reflux11

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Community Hospital Association CurrentSince Nov 13, 2021 Accepting new patients
Memorial Community Hospital Corporation CurrentSince Jun 1, 2023 Accepting new patients
Memorial Community Hospital Corporation Family Medicine CurrentSince Jun 1, 2023 Accepting new patients
Community Hospital Association Family Medicine CurrentSince Nov 13, 2021 Accepting new patients
Community Hospital Association Current Accepting new patients

Locations

810 N 22nd St
Blair, NE 68008
Phone (402) 426-1116

812 N 22nd St
Blair, NE 68008
Phone (402) 426-4611

1301 E H St
McCook, NE 69001
Phone (308) 344-2650

1401 E H St
McCook, NE 69001
Phone (308) 344-4110

Networks

  • devoted network organization-2b183dd2-4e80-4977-80a6-4fdf0df4361d
  • IA HMO C-SNP
  • CO HMO
  • devoted network organization-a4751131-f16f-4e82-8f2b-b08e66379a7a
  • CO HMO D-SNP
  • IA HMO

Interoperability endpoints

  • Direct secure messaging: seanerickson@mccpc.allscriptsdirect.net

Organizations & group practices 5

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.

Hospital & facility affiliations 5

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

NPI Registry JSON

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

{
    "created_epoch": "1560297600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1694390400000",
    "number": "1023677176",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "812 N 22ND ST",
            "city": "BLAIR",
            "state": "NE",
            "postal_code": "680081128",
            "telephone_number": "402-426-4611",
            "fax_number": "402-426-4642"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "812 N 22ND ST",
            "city": "BLAIR",
            "state": "NE",
            "postal_code": "680081128",
            "telephone_number": "402-426-4611",
            "fax_number": "402-426-4642"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ERICKSON",
        "first_name": "SEAN",
        "middle_name": "C.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-06-12",
        "last_updated": "2023-09-11",
        "certification_date": "2023-09-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NE",
            "license": "33115",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Blair, NE

Sources for this page

Verify at the official NPI Registry.