Individual provider Active NPI

Rebecca Sue Erickson, OCULARIST

  • Ocularist
  • Seattle, WA
National Provider Identifier
1164580270
Registry record updated Jun 7, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
OcularistTaxonomy code 156FX1700X
License
OS 00000016 Issued in WA
Practice address
509 Olive Way
Suite 1421
Seattle, WA 98101-1749
Phone
(206) 622-9175
Fax
(206) 622-9378
NPI assigned
Dec 4, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 7, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Ocularist 156FX1700X OS 00000016 WA Primary

Addresses

Primary practice location

509 Olive Way
Suite 1421
Seattle, WA 98101-1749

Mailing address

509 Olive Way
Suite 1421
Seattle, WA 98101-1749
Phone (206) 622-9175

Other identifiers 1

IdentifierTypeStateIssuer
9111006MedicaidWA

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)
Not enrolled

State licenses

LicenseStateTypeSpecialty
OS 00000016WAMDOcularist

Practice roles

OrganizationSpecialtyStatusNew patients
Erickson Laboratories, Inc Ocularist Current Accepting new patients

Locations

509 Olive Way
Ste 1421
Seattle, WA 98101
Phone (206) 622-9175

Organizations & group practices 1

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": "1165190400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1339027200000",
    "number": "1164580270",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "509 OLIVE WAY",
            "address_2": "SUITE 1421",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981011749",
            "telephone_number": "206-622-9175",
            "fax_number": "206-622-9378"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "509 OLIVE WAY",
            "address_2": "SUITE 1421",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981011749",
            "telephone_number": "206-622-9175",
            "fax_number": "206-622-9378"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ERICKSON",
        "first_name": "REBECCA",
        "middle_name": "SUE",
        "credential": "OCULARIST",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-12-04",
        "last_updated": "2012-06-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "156FX1700X",
            "taxonomy_group": "",
            "desc": "Technician/Technologist, Ocularist",
            "state": "WA",
            "license": "OS 00000016",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "9111006",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Seattle, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 7, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.