Mark R Erickson, P.T.

Primary specialty

Orthopedic Physical TherapistTaxonomy code 2251X0800X

License

2755-024 Issued in WI

Practice address

161 W Wisconsin Ave
Pewaukee, WI 53072-3467

Phone

(262) 349-8424

NPI assigned

Jun 30, 2011

Last updated

Jun 30, 2011By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1309392000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1309392000000",
    "number": "1225325111",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "305 WOODLANDS CT",
            "city": "HARTLAND",
            "state": "WI",
            "postal_code": "530292295",
            "telephone_number": "262-349-8424"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "161 W WISCONSIN AVE",
            "city": "PEWAUKEE",
            "state": "WI",
            "postal_code": "530723467",
            "telephone_number": "262-349-8424"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ERICKSON",
        "first_name": "MARK",
        "middle_name": "R",
        "name_prefix": "Dr.",
        "credential": "P.T.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-06-30",
        "last_updated": "2011-06-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2251H1300X",
            "taxonomy_group": "",
            "desc": "Physical Therapist, Human Factors",
            "state": "WI",
            "license": "2755-024",
            "primary": false
        },
        {
            "code": "2251S0007X",
            "taxonomy_group": "",
            "desc": "Physical Therapist, Sports",
            "state": "WI",
            "license": "2755-024",
            "primary": false
        },
        {
            "code": "2251X0800X",
            "taxonomy_group": "",
            "desc": "Physical Therapist, Orthopedic",
            "state": "WI",
            "license": "2755-024",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Jon Michael Englund, M.D.
• Eric Ehrke LLC
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• Sarah A. Ezerins, OT
• Lori R Fairbairn, MFT
• Faithful Physician Services LLC (Faithful Physician Services)
• Janelle Ann Ferber Stumpf, DDS

• Orthopedic Physical Therapist in Pewaukee, WI
• Providers in Pewaukee, WI by specialty
• Orthopedic Physical Therapist in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 30, 2011; 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.