Individual provider Active NPI

Robert James Erickson, D.C.

  • Chiropractor
  • Faribault, MN
National Provider Identifier
1255374344
Registry record updated Jul 9, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
2235 Issued in MN
Practice address
200 8TH Ave NW
Suite 5
Faribault, MN 55021
Phone
(507) 334-9400
Fax
(507) 331-2210
NPI assigned
Jun 14, 2006
Last updated
Jul 9, 2007By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 9, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 2235 MN Primary

Addresses

Primary practice location

200 8TH Ave NW
Suite 5
Faribault, MN 55021

Mailing address

200 8TH Ave NW
Suite 5
Faribault, MN 55021-5068
Phone (507) 334-9400

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MN

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040209000074 MN Practitioner - Chiropractic 8022901495 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Northwestern College of Chiropractic, 1985
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Dr Robert J Erickson PAGroup PAC ID 9739073024, 2 clinicians

Practice addresses (Care Compare)

1819 2ND Ave NW
Faribault, MN 55021-3035
Phone (507) 334-9400

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2235MNMDMarriage & Family Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Dr. Robert J. Erickson, P.a. Chiropractor CurrentSince Jan 1, 1986 Accepting new patients
Back in Action Rehab, LLP PastSince Feb 1, 1996 Accepting new patients

Locations

1819 2nd Ave NW
Faribault, MN 55021
Phone (507) 334-5627

200 8th Ave NW
Ste 5
Faribault, MN 55021
Phone (507) 334-9400

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1150243200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183939200000",
    "number": "1255374344",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 8TH AVE NW",
            "address_2": "SUITE 5",
            "city": "FARIBAULT",
            "state": "MN",
            "postal_code": "550215068",
            "telephone_number": "507-334-9400",
            "fax_number": "507-331-2210"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 8TH AVE NW",
            "address_2": "SUITE 5",
            "city": "FARIBAULT",
            "state": "MN",
            "postal_code": "55021",
            "telephone_number": "507-334-9400",
            "fax_number": "507-331-2210"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ERICKSON",
        "first_name": "ROBERT",
        "middle_name": "JAMES",
        "credential": "D.C.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-14",
        "last_updated": "2007-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "MN",
            "license": "2235",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Faribault, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • 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.