Individual provider Active NPI

Erica Herdecker

  • Family Nurse Practitioner
  • Severna Park, MD
National Provider Identifier
1033999545
Registry record updated Oct 2, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
R222626 Issued in MD
Practice address
560 Jumpers Hole Rd
Severna Park, MD 21146-2654
Phone
(301) 788-8506
NPI assigned
Oct 2, 2023
Last updated
Oct 2, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 2, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X R222626 MD Primary

Addresses

Primary practice location

560 Jumpers Hole Rd
Severna Park, MD 21146-2654

Mailing address

560 Jumpers Hole Rd
Severna Park, MD 21146-2654

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
R222626MDMDFamily Nurse Practitioner

Interoperability endpoints

  • Direct secure messaging: eherdecker313816@direct.hopkinsmedicine.org

NPI Registry JSON

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

{
    "created_epoch": "1696204800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1696204800000",
    "number": "1033999545",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "560 JUMPERS HOLE RD",
            "city": "SEVERNA PARK",
            "state": "MD",
            "postal_code": "211462654"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "560 JUMPERS HOLE RD",
            "city": "SEVERNA PARK",
            "state": "MD",
            "postal_code": "211462654",
            "telephone_number": "301-788-8506"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HERDECKER",
        "first_name": "ERICA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-10-02",
        "last_updated": "2023-10-02",
        "certification_date": "2023-10-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MD",
            "license": "R222626",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Severna Park, MD

Sources for this page

Verify at the official NPI Registry.