Kent Edwin Erickson, MD

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

04-22435 Issued in KS

Practice address

409 Lincoln Ave
Erickson Medical Clinic, LLC
Clay Center, KS 67432-2907

Phone

(785) 777-2622

Fax

(785) 777-2623

NPI assigned

May 24, 2005

Last updated

Jun 16, 2016By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in KS

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Family PracticeAlso: Geriatric Medicine

Education

University of Kansas School of Med (KC/Wich/Sal), 1983

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Erickson Medical Clinic LLCGroup PAC ID 1456648740, 2 clinicians

Clay County Medical CenterGroup PAC ID 6901959436, shared by 8 NPIs, 44 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Clay County Medical Center Hospital, Clay Center, KS, CCN 171371
• Linn Community Nursing Home Nursing home, Linn, KS, CCN 175494
• Leonardville Nursing Home Nursing home, Leonardville, KS, CCN 175477

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: kent.erickson@31895190175748.direct.elationemr.com
• Direct secure messaging: kent.erickson@khindirect.org

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.

• Erickson Medical Clinic, LLC

  • Primary Care Clinic/Center
  • Clay Center, KS
  • NPI 1689029464
  Medicare reassignment Care Compare group NPD Authorized official

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

• Clay County Medical Center

  • Critical Access Hospital
  • Clay Center, KS
  • NPI 1265485817
  Care Compare affiliation
• Leonardville Nursing Home, Inc

  • Skilled Nursing Facility
  • Leonardville, KS
  • NPI 1265446041

  Nursing home

  Care Compare affiliation
• Linn Community Nursing Home Inc.

  • Skilled Nursing Facility
  • Linn, KS
  • NPI 1982632048

  Nursing home

  Care Compare affiliation

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

{
    "created_epoch": "1116892800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1466035200000",
    "number": "1073516035",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1024 LANE ST",
            "address_2": "ERICKSON MEDICAL CLINIC",
            "city": "CLAY CENTER",
            "state": "KS",
            "postal_code": "674322211",
            "telephone_number": "785-632-6415",
            "fax_number": "785-632-2309"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "409 LINCOLN AVE",
            "address_2": "ERICKSON MEDICAL CLINIC, LLC",
            "city": "CLAY CENTER",
            "state": "KS",
            "postal_code": "674322907",
            "telephone_number": "785-777-2622",
            "fax_number": "785-777-2623"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ERICKSON",
        "first_name": "KENT",
        "middle_name": "EDWIN",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-05-24",
        "last_updated": "2016-06-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "KS",
            "license": "22435",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "KS",
            "license": "04-22435",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100208950A",
            "state": "KS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• County of Clay (Clay County Health Department)
• Mary Kay Cummins, ARNP
• Tricia Aubrey Cunningham
• Emily Elizabeth Ebert, FNP-C
• Erickson Medical Clinic, LLC
• Joseph Garrett Ferguson, DDS
• Jericho Fief, COTA
• Joshua B Girard, D.C.
• Austin Keith Gydesen, APRN
• Randall R Hafner, D.C.

• Family Medicine Physician in Clay Center, KS
• Providers in Clay Center, KS by specialty
• Family Medicine Physician in Kansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 16, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.