Jay S Erickson, MD

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

6585 Issued in MT

Practice address

1111 Baker Ave
Glacier Medical Associates
Whitefish, MT 59937-2901

Phone

(406) 862-2515

Fax

(406) 862-4229

NPI assigned

Sep 20, 2006

Last updated

May 12, 2008By 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 1

Addresses

Other identifiers 9

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

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.

• Logan Health - Whitefish

  dba Logan Health Rural Health Clinic- Eureka

  • Rural Health Clinic/Center
  • Eureka, MT
  • NPI 1336115849
  NPD (past)

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

{
    "created_epoch": "1158710400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1210550400000",
    "number": "1235237660",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1111 BAKER AVE",
            "address_2": "GLACIER MEDICAL ASSOCIATES",
            "city": "WHITEFISH",
            "state": "MT",
            "postal_code": "599372901",
            "telephone_number": "406-862-2515",
            "fax_number": "406-862-4229"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1111 BAKER AVE",
            "address_2": "GLACIER MEDICAL ASSOCIATES",
            "city": "WHITEFISH",
            "state": "MT",
            "postal_code": "599372901",
            "telephone_number": "406-862-2515",
            "fax_number": "406-862-4229"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ERICKSON",
        "first_name": "JAY",
        "middle_name": "S",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-20",
        "last_updated": "2008-05-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MT",
            "license": "6585",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE GRP ID#",
            "identifier": "CI2709",
            "state": "MT"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0085163",
            "state": "MT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MONTANA STATE LICENSE",
            "identifier": "6585",
            "state": "MT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS/BLUE SHIELD",
            "identifier": "000000061",
            "state": "MT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE PIN#",
            "identifier": "080026846",
            "state": "MT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GLACIER MEDICAL ASSOC NPI",
            "identifier": "1104882232",
            "state": "MT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "FEIN",
            "identifier": "810350909",
            "state": "MT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PART B GRP ID#",
            "identifier": "000008287",
            "state": "MT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CLIA ID#--LAB CERT",
            "identifier": "27D0411341",
            "state": "MT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Jennifer Elden, LMT
• Ember Nutrition and Training LLC
• Empres at Whitefish, LLC (Whitefish Health and Rehabilitation Center)
• Gaelen Engler
• Eric Daniels DDS
• Erin Adams-Griffin LLC (Erin Adams-Griffin, LCSW, LAC)
• Alicia Nichole Evans
• Myki L Evans, LMT
• Falling From Trees, LLC (Flora Medical Massage and Bodywork Clinic)
• Jordan Alexandra Fennelly, DC

• Family Medicine Physician in Whitefish, MT
• Providers in Whitefish, MT by specialty
• Family Medicine Physician in Montana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 12, 2008; 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.