Dallin T Erickson, DO

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

12302759-1204 Issued in UT

Practice address

5740 Crestwood Dr
Ogden, UT 84405-4869

Phone

(801) 479-7771

NPI assigned

Mar 29, 2018

Last updated

Jun 15, 2021By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in UT

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Family Practice

Education

At Still Un of HLTH Sciences, Col of Osteo Med, Mesa, 2018

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Ogden Clinic PCGroup PAC ID 9638078033, 104 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Atlas Home Care Home health agency, Layton, UT, CCN 467232
• Ogden Regional Medical Center Hospital, Ogden, UT, CCN 460005
• Intermountain Health McKay-Dee Hospital Hospital, Ogden, UT, CCN 460004

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Ogden Clinic PC

  • Family Medicine Physician
  • Ogden, UT
  • NPI 1578550083
  Medicare reassignment Care Compare group NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Columbia Ogden Medical Center, Inc.

  dba Ogden Regional Medical Center

  • General Acute Care Hospital
  • Ogden, UT
  • NPI 1720031636
  Care Compare affiliation
• Ihc Health Services Inc

  dba Intermountain Health McKay-Dee Hospital

  • General Acute Care Hospital
  • Ogden, UT
  • NPI 1194749580
  Care Compare affiliation
• Legacy Health Care Inc

  • Home Health Agency
  • Layton, UT
  • NPI 1952417214
  Care Compare affiliation

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

{
    "created_epoch": "1522281600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1623715200000",
    "number": "1164927133",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 5546",
            "city": "DENVER",
            "state": "CO",
            "postal_code": "802175546",
            "telephone_number": "801-475-3500",
            "fax_number": "801-475-3489"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5740 CRESTWOOD DR",
            "city": "OGDEN",
            "state": "UT",
            "postal_code": "844054869",
            "telephone_number": "801-479-7771"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ERICKSON",
        "first_name": "DALLIN",
        "middle_name": "T",
        "credential": "DO",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2018-03-29",
        "last_updated": "2021-06-15",
        "certification_date": "2021-06-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "UT",
            "license": "12302759-1204",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1164927133",
            "state": "UT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Tonya England
• Enhanced Diagnostics
• Angela Epstein, PA-C
• Noah John Elo Erb
• Eric G Russell DDS LLC
• Preston Erickson
• Jacqueline Ermini
• Karlie Ervin
• Stephen Patrick Escobar
• Robert C Esquibel, RPH

• Family Medicine Physician in Ogden, UT
• Providers in Ogden, UT by specialty
• Family Medicine Physician in Utah

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 15, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.