Individual provider Active NPI

Erika Rae Scanlon, PMHNP-BC

  • Psychiatric/Mental Health Nurse Practitioner
  • Boston, MA
National Provider Identifier
1366712010
Registry record updated Aug 25, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
RN2270503 Issued in MA
Practice address
100 Cambridge St FL 14
Boston, MA 02114-2509
Phone
(508) 960-9242
Fax
(617) 885-0158
NPI assigned
Jan 11, 2012
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 25, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X RN2270503 MA Primary
Registered Nurse 163W00000X 2270503 MA

Addresses

Primary practice location

100 Cambridge St FL 14
Boston, MA 02114-2509

Mailing address

47 Obery St
Plymouth, MA 02360-2229
Phone (508) 746-8590

Other practice location 1

47 Obery St
Plymouth, MA 02360-2229
Phone (508) 746-8590

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA
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
I20121127000026 MA Practitioner - Nurse Practitioner 7416108337 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Gosnold, Inc.Group PAC ID 5991776627, 13 clinicians
Jordan Physician Associates IncGroup PAC ID 1254321086, 166 clinicians

Practice addresses (Care Compare)

1185 Falmouth Rd
Centerville, MA 02632-3066
Phone (508) 540-6550

46 Obery St
Plymouth, MA 02360-2237
Phone (508) 210-5920

909 Sumner St
Stoughton, MA 02072-3396
Phone (508) 540-6550

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2270503MAMDRegistered Nurse
RN2270503MAMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Jordan Physician Associates, Inc. CurrentSince Apr 6, 2026 Accepting new patients
Jordan Physician Associates, Inc. CurrentSince Apr 6, 2026 Accepting new patients

Locations

46 Obery St
Plymouth, MA 02360
Phone (508) 210-5920

47 Obery St
Plymouth, MA 02360
Phone (508) 746-8590

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": "1326240000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1787616000000",
    "number": "1366712010",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "47 OBERY ST",
            "city": "PLYMOUTH",
            "state": "MA",
            "postal_code": "023602229",
            "telephone_number": "508-746-8590"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 CAMBRIDGE ST FL 14",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "021142509",
            "telephone_number": "508-960-9242",
            "fax_number": "617-885-0158"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "47 Obery St",
            "address_purpose": "LOCATION",
            "city": "Plymouth",
            "state": "MA",
            "postal_code": "023602229",
            "country_code": "US",
            "telephone_number": "508-746-8590",
            "fax_number": "508-830-2062",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SCANLON",
        "first_name": "ERIKA",
        "middle_name": "RAE",
        "name_prefix": "Miss",
        "credential": "PMHNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-01-11",
        "last_updated": "2026-08-25",
        "certification_date": "2026-08-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "MA",
            "license": "RN2270503",
            "primary": true
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "MA",
            "license": "2270503",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Boston, MA

Sources for this page

Verify at the official NPI Registry.