NPIMap

Individual provider Active NPI

Raymond S Erickson, APRN-BC

  • Medical-Surgical Clinical Nurse Specialist
  • Columbia, MO
National Provider Identifier
1154314623
Registry record updated Jul 30, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical-Surgical Clinical Nurse SpecialistTaxonomy code 364SM0705X
License
145779 Issued in MO
Practice address
1 S Keene St
Columbia, MO 65201-7199
Phone
(573) 443-2402
Fax
(573) 443-0574
NPI assigned
Aug 30, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 30, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medical-Surgical Clinical Nurse Specialist 364SM0705X 145779 MO Primary

Addresses

Primary practice location

1 S Keene St
Columbia, MO 65201-7199

Mailing address

1 S Keene St
Columbia, MO 65201-7199
Phone (573) 443-2402

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MO, KS2 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20080514000294 MO Practitioner - Certified Clinical Nurse Specialist (CNS) 3870543440 Reassigns benefits to 1 organization
I20221223000897 KS Practitioner - Certified Clinical Nurse Specialist (CNS) 3870543440 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Certified Clinical Nurse Specialist (CNS)
Education
Other, 2004
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Dickson Diveley Midwest Orthopaedic Clinic LLCGroup PAC ID 1153225479, 66 clinicians

Practice addresses (Care Compare)

3651 College Blvd
Leawood, KS 66211-1910
Phone (913) 319-7600

Hospital & facility affiliations

  • Kansas City Orthopaedic Institute Hospital, Leawood, KS, CCN 170188
  • Adventhealth Shawnee Mission Hospital, Shawnee Mission, KS, CCN 170104
  • University of Kansas Hospital Hospital, Kansas City, KS, CCN 170040
  • St Lukes Hospital of Kansas City Hospital, Kansas City, MO, CCN 260138

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Certified Nurse Specialist, Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
145779MOMDMedical-Surgical Clinical Nurse Specialist

Practice roles

OrganizationSpecialtyStatusNew patients
Columbia Orthopaedic Group, LLP CurrentSince Sep 27, 2004 Accepting new patients
Dickson Diveley Midwest Orthopaedic Clinic LLC CurrentSince Dec 21, 2022 Accepting new patients
Columbia Orthopaedic Group, LLP CurrentSince Sep 27, 2004 Accepting new patients
Dickson Diveley Midwest Orthopaedic Clinic LLC CurrentSince Dec 21, 2022 Accepting new patients
Main Line Healthcare Past Accepting new patients

Locations

3651 College Blvd
Ste 100B
Leawood, KS 66211
Phone (913) 362-0031

3651 W 111th St
Overland Park, KS 66211
Phone (800) 876-5958

10777 Nall Ave
Ste 300
Overland Park, KS 66211
Phone (913) 257-6259

7450 Kessler St
Ste 140
Shawnee Mission, KS 66204
Phone (913) 319-7600

17067 S Outer Rd
Ste 301
Belton, MO 64012
Phone (913) 257-6259

201 W Road Mize Rd
Ste 200
Blue Springs, MO 64014
Phone (913) 319-7600

1 S Keene St
Columbia, MO 65201
Phone (573) 443-2402

4320 Wornall Rd
Ste 610
Kansas City, MO 64111
Phone (913) 319-7600

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 and National Provider Directory roles.

Hospital & facility affiliations 8

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": "1125360000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1217376000000",
    "number": "1154314623",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 S KEENE ST",
            "city": "COLUMBIA",
            "state": "MO",
            "postal_code": "652017199",
            "telephone_number": "573-443-2402",
            "fax_number": "573-443-0574"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 S KEENE ST",
            "city": "COLUMBIA",
            "state": "MO",
            "postal_code": "652017199",
            "telephone_number": "573-443-2402",
            "fax_number": "573-443-0574"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ERICKSON",
        "first_name": "RAYMOND",
        "middle_name": "S",
        "credential": "APRN-BC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-08-30",
        "last_updated": "2008-07-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "364SM0705X",
            "taxonomy_group": "",
            "desc": "Clinical Nurse Specialist, Medical-Surgical",
            "state": "MO",
            "license": "145779",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Columbia, MO

Sources for this page

Verify at the official NPI Registry.