Individual provider Active NPI

Scott Erickson, ARNP

  • Family Nurse Practitioner
  • Wellington, FL
National Provider Identifier
1154789428
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
ARNP9283734 Issued in FL
Practice address
13421 S Shore Blvd Ste 101
Wellington, FL 33414-7210
Phone
(561) 440-1616
Fax
(561) 440-2030
NPI assigned
Feb 2, 2016
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X RN9283734 FL
Family Nurse Practitioner 363LF0000X ARNP9283734 FL Primary

Addresses

Primary practice location

13421 S Shore Blvd Ste 101
Wellington, FL 33414-7210

Mailing address

367 S. Gulph Rd
Att: Ipm Credentialing
King of Prussia, PA 19406-3121
Phone (775) 356-9393

Other practice location 1

13880 69th St N
West Palm Beach, FL 33412-1970
Phone (561) 379-5844

Other identifiers 1

IdentifierTypeStateIssuer
021817400MedicaidFL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20160414000005 FL Practitioner - Nurse Practitioner 5991003626 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
ARNP9283734FLMDFamily Nurse Practitioner
RN9283734FLMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Em Alliance LLC CurrentSince Oct 10, 2023 Accepting new patients
Wrmcabns, LLC PastSince Aug 1, 2017 Accepting new patients

Locations

5506 14th St W
Bradenton, FL 34207
Phone (941) 745-7372

10101 Forest Hill Blvd
West Palm Beach, FL 33414
Phone (561) 766-1301

7 Easton Oval
#L4387
Columbus, OH 43219

Interoperability endpoints

  • FHIR API: https://fhir-myrecord.cerner.com/r4/KOZ64ZU-fJam5DNQB3C21wHed7uKMN5J/

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1454371200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1154789428",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "367 S. GULPH RD",
            "address_2": "ATT: IPM CREDENTIALING",
            "city": "KING OF PRUSSIA",
            "state": "PA",
            "postal_code": "194063121",
            "telephone_number": "775-356-9393",
            "fax_number": "775-356-5590"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13421 S SHORE BLVD STE 101",
            "city": "WELLINGTON",
            "state": "FL",
            "postal_code": "334147210",
            "telephone_number": "561-440-1616",
            "fax_number": "561-440-2030"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "13880 69th St N",
            "address_purpose": "LOCATION",
            "city": "West Palm Beach",
            "state": "FL",
            "postal_code": "334121970",
            "country_code": "US",
            "telephone_number": "561-379-5844",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ERICKSON",
        "first_name": "SCOTT",
        "credential": "ARNP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-02-02",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "FL",
            "license": "RN9283734",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "FL",
            "license": "ARNP9283734",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "021817400",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Wellington, FL

Sources for this page

Verify at the official NPI Registry.