Individual provider Active NPI

Jessica Ericson, NP

  • Occupational Health Nurse Practitioner
  • Atlanta, GA
National Provider Identifier
1285302513
Registry record updated Sep 1, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational Health Nurse PractitionerTaxonomy code 363LX0106X
License
RN159498 Issued in GA
Practice address
1364 Clifton Rd NE Ste D219
Atlanta, GA 30322-1059
Phone
(404) 712-2093
Fax
(404) 686-7076
NPI assigned
Sep 1, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 1, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Health Nurse Practitioner 363LX0106X RN159498 GA Primary

Addresses

Primary practice location

1364 Clifton Rd NE Ste D219
Atlanta, GA 30322-1059

Mailing address

620 Glen Iris Dr NE Unit 407
Atlanta, GA 30308-2770
Phone (404) 290-4756

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
RN159498GAMDOccupational Health Nurse Practitioner

NPI Registry JSON

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

{
    "created_epoch": "1630454400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1630454400000",
    "number": "1285302513",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "620 GLEN IRIS DR NE UNIT 407",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303082770",
            "telephone_number": "404-290-4756"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1364 CLIFTON RD NE STE D219",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303221059",
            "telephone_number": "404-712-2093",
            "fax_number": "404-686-7076"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ERICSON",
        "first_name": "JESSICA",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-09-01",
        "last_updated": "2021-09-01",
        "certification_date": "2021-09-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LX0106X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Occupational Health",
            "state": "GA",
            "license": "RN159498",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Atlanta, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 1, 2021; 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.