Active NPI
Brian E Erdrich, ANP
- Family Nurse Practitioner
- Anchorage, AK
National Provider Identifier
1154568376
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Nurse Practitioner
- License
- 1229
- Practice address
- 2925 Debarr Rd Ste 240
Anchorage, AK 99508-2959 - Phone
- (907) 339-4650
- Fax
- (907) 339-4694
- NPI assigned
- Jan 9, 2009
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Critical Care Medicine Registered Nurse | 163WC0200X | 19840 | AK | |
| Family Nurse Practitioner | 363LF0000X | 1229 | AK | Primary |
Addresses
Primary practice location
2925 Debarr Rd Ste 240
Anchorage, AK 99508-2959
Mailing address
2925 Debarr Rd Ste 240
Anchorage, AK 99508-2959
Phone (907) 339-4650
Other practice location 1
3200 Providence Dr
Anchorage, AK 99508-4615
Phone (907) 212-6284
Other practice location 2
3200 Providence Dr
Anchorage, AK 99508-4615
Phone (907) 212-6284
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1576654 | Medicaid | AK |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 19840 | AK | MD | Critical Care Medicine Registered Nurse |
| 1229 | AK | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1231459200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1521244800000",
"number": "1154568376",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2925 DEBARR RD STE 240",
"city": "ANCHORAGE",
"state": "AK",
"postal_code": "995082959",
"telephone_number": "907-339-4650",
"fax_number": "907-339-4694"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2925 DEBARR RD STE 240",
"city": "ANCHORAGE",
"state": "AK",
"postal_code": "995082959",
"telephone_number": "907-339-4650",
"fax_number": "907-339-4694"
}
],
"practiceLocations": [
{
"address_1": "3200 Providence Dr",
"address_purpose": "LOCATION",
"city": "Anchorage",
"state": "AK",
"postal_code": "995084615",
"country_code": "US",
"telephone_number": "907-212-6284",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "3200 Providence Dr",
"address_purpose": "LOCATION",
"city": "Anchorage",
"state": "AK",
"postal_code": "995084615",
"country_code": "US",
"telephone_number": "907-212-6284",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "ERDRICH",
"first_name": "BRIAN",
"middle_name": "E",
"credential": "ANP",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2009-01-09",
"last_updated": "2018-03-17",
"status": "A"
},
"taxonomies": [
{
"code": "163WC0200X",
"taxonomy_group": "",
"desc": "Registered Nurse, Critical Care Medicine",
"state": "AK",
"license": "19840",
"primary": false
},
{
"code": "363LF0000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Family",
"state": "AK",
"license": "1229",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1576654",
"state": "AK"
}
],
"endpoints": [],
"other_names": []
}Other providers in Anchorage, AK
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.