Active NPI
Amina Erickson
- Massage Therapist
- De Pere, WI
National Provider Identifier
1295433910
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Massage Therapist
- License
- 15431-146
- Practice address
- 502 George St
De Pere, WI 54115-2772 - Phone
- (920) 337-0103
- NPI assigned
- Feb 21, 2023
- Last updated
- Feb 21, 2023
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Massage Therapist | 225700000X | 15431-146 | WI | Primary |
Addresses
Primary practice location
502 George St
De Pere, WI 54115-2772
Mailing address
2307 Sunny LN Apt P
Suamico, WI 54313-7864
Phone (920) 888-0038
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 15431-146 | WI | MD | Massage Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Van Drisse Chiropractic Center LLC | Current | Accepting new patients |
Locations
502 George St
De Pere, WI 54115
Phone (920) 337-0103
Organizations & group practices 1
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.
-
- Chiropractor
- De Pere, WI
- NPI 1194913434
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1676937600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1676937600000",
"number": "1295433910",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2307 SUNNY LN APT P",
"city": "SUAMICO",
"state": "WI",
"postal_code": "543137864",
"telephone_number": "920-888-0038"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "502 GEORGE ST",
"city": "DE PERE",
"state": "WI",
"postal_code": "541152772",
"telephone_number": "920-337-0103"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ERICKSON",
"first_name": "AMINA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2023-02-21",
"last_updated": "2023-02-21",
"certification_date": "2023-02-21",
"status": "A"
},
"taxonomies": [
{
"code": "225700000X",
"taxonomy_group": "",
"desc": "Massage Therapist",
"state": "WI",
"license": "15431-146",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in De Pere, WI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 21, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.