Individual provider Active NPI

Katie Lynne Erickson, FNP

  • Family Nurse Practitioner
  • Fort Worth, TX
National Provider Identifier
1326287665
Registry record updated May 24, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
675806 Issued in TX
Practice address
1307 8TH Ave.,
Suite 506
Fort Worth, TX 76104-4142
Phone
(817) 332-6092
Fax
(817) 332-6015
NPI assigned
Feb 10, 2009
Last updated
May 24, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 24, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 675806 TX Primary

Addresses

Primary practice location

1307 8TH Ave.,
Suite 506
Fort Worth, TX 76104-4142

Mailing address

P. O. Box 961205
Fort Worth, TX 76161-1205
Phone (817) 740-8400

Other identifiers 1

IdentifierTypeStateIssuer
213477701MedicaidTX

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AL
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240606000146 AL Practitioner - Nurse Practitioner 0648299578 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Fast Pace Medical Clinic PLLCGroup PAC ID 5395881841, 737 clinicians

Practice addresses (Care Compare)

2451 Diberville Dr N
Mobile, AL 36695-3628
Phone (251) 444-4670

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
675806TXMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Fast Pace Medical Clinic PLLC CurrentSince Jun 1, 2024 Accepting new patients
Upperline Healthcare, PC CurrentSince Sep 1, 2025 Accepting new patients
Upperline Healthcare, PC Nurse Practitioner CurrentSince Sep 1, 2025 Accepting new patients
Fast Pace Medical Clinic PLLC CurrentSince Jun 1, 2024 Accepting new patients
Domicilliary Service LLC Past Accepting new patients

Locations

9932 Spanish Fort Blvd
Daphne, AL 36527
Phone (251) 237-8181

416 N Seminary St
Ste 1100
Florence, AL 35630
Phone (256) 284-7280

517 S McKenzie St
Foley, AL 36535
Phone (251) 200-4499

6316 Piccadilly Square Dr
#A
Mobile, AL 36609
Phone (205) 822-8038

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/25344/brand/1/csg/1/fhir/r4

Organizations & group practices 5

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": "1234224000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1716508800000",
    "number": "1326287665",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "P. O. BOX 961205",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761611205",
            "telephone_number": "817-740-8400",
            "fax_number": "817-332-6015"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1307 8TH AVE.,",
            "address_2": "SUITE 506",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761044142",
            "telephone_number": "817-332-6092",
            "fax_number": "817-332-6015"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ERICKSON",
        "first_name": "KATIE",
        "middle_name": "LYNNE",
        "name_prefix": "Mrs.",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-02-10",
        "last_updated": "2024-05-24",
        "certification_date": "2024-05-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TX",
            "license": "675806",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "213477701",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Worth, TX

Sources for this page

Verify at the official NPI Registry.