Individual provider Active NPI

Elizabeth Eriksson, ARNP, ANP-BC

  • Adult Health Nurse Practitioner
  • Daytona Beach, FL
National Provider Identifier
1275869596
Registry record updated Jul 5, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Health Nurse PractitionerTaxonomy code 363LA2200X
License
ARNP3354322 Issued in FL
Practice address
1893 N Clyde Morris Blvd Ste 120
Daytona Beach, FL 32117-5536
Phone
(386) 675-6778
Fax
(386) 675-6782
NPI assigned
Oct 21, 2009
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 5, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Health Nurse Practitioner 363LA2200X 3354322 FL
Adult Health Nurse Practitioner 363LA2200X ARNP3354322 FL Primary

Addresses

Primary practice location

1893 N Clyde Morris Blvd Ste 120
Daytona Beach, FL 32117-5536

Mailing address

1893 N Clyde Morris Blvd Ste 120
Daytona Beach, FL 32117-5536
Phone (386) 675-6778

Other practice location 1

50 S B B King Blvd
Memphis, TN 38103-2626
Phone (901) 436-1381

Other identifiers 1

IdentifierTypeStateIssuer
009122900MedicaidFL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
3354322FLMDAdult Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Family Medical Care of Palm Coast LLC Past Accepting new patients
American Arthritis & Rheumatology Associates LLC Past Accepting new patients
Arthritis Autoimmune and Allergy PastSince May 15, 2007 Accepting new patients

Networks

  • Freedom Health HMO Network
  • Optimum HealthCare HMO Network

Interoperability endpoints

  • FHIR API: https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/
  • Direct secure messaging: ms_eeriksso@landmarkhealth-direct.org

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1256083200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1656979200000",
    "number": "1275869596",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1893 N CLYDE MORRIS BLVD STE 120",
            "city": "DAYTONA BEACH",
            "state": "FL",
            "postal_code": "321175536",
            "telephone_number": "386-675-6778",
            "fax_number": "386-675-6782"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1893 N CLYDE MORRIS BLVD STE 120",
            "city": "DAYTONA BEACH",
            "state": "FL",
            "postal_code": "321175536",
            "telephone_number": "386-675-6778",
            "fax_number": "386-675-6782"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "50 S B B King Blvd",
            "address_purpose": "LOCATION",
            "city": "Memphis",
            "state": "TN",
            "postal_code": "381032626",
            "country_code": "US",
            "telephone_number": "901-436-1381",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ERIKSSON",
        "first_name": "ELIZABETH",
        "credential": "ARNP, ANP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-10-21",
        "last_updated": "2022-07-05",
        "certification_date": "2022-07-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "FL",
            "license": "3354322",
            "primary": false
        },
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "FL",
            "license": "ARNP3354322",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "009122900",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Daytona Beach, FL

Sources for this page

Verify at the official NPI Registry.