Lynn Ellen Erickson-Meier, NBS-HIS #623

Individual provider Active NPI Hearing Instrument Specialist · Waterford, WI

NPI 1164697215 · NPPES record last updated Jun 17, 2010

Key facts

NPI
1164697215
Entity type
Individual (NPI type 1)
Primary specialty
Hearing Instrument Specialist 237700000X
License
NBC-HIS623 (WI)
Practice address
4525 Gunderson Road
Waterford, WI 53185-3711
Phone
(262) 335-2327
Fax
(262) 335-2528
NPI assigned
Apr 29, 2008
Sex
Female
Sole proprietor
Yes

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.

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
623WIMDHearing Instrument Specialist
NBC-HIS623WIMDHearing Instrument Specialist

Practice roles

OrganizationSpecialtyStatusNew patients
Community Foot and Ankle Clinic, Inc. Past Accepting new patients
Dolphin Manor Adult Day Program Past Accepting new patients

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/6854/brand/1/csg/1/fhir/r4

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Hearing Instrument Specialist 237700000X 623 WI
Hearing Instrument Specialist 237700000X NBC-HIS623 WI Yes

Addresses

Primary practice location

4525 Gunderson Road
Waterford, WI 53185-3711

Mailing address

4525 Gunderson Road
Waterford, WI 53185-3711
Phone (262) 483-4327

Other identifiers

IdentifierTypeStateIssuer
42837000MedicaidWI

Other providers in Waterford, WI

All providers in Waterford, WI · Hearing Instrument Specialist in Wisconsin

Sources for this page

Verify at the official NPI Registry.