Mary-Alice Rodstrom Ernst, A.N.P.

Primary specialty

Adult Health Nurse PractitionerTaxonomy code 363LA2200X

License

201050211NP Issued in OR

Practice address

1590 E. 13TH St
Eugene, OR 97403-1232

Phone

(541) 346-2770

Fax

(541) 346-2747

NPI assigned

Apr 1, 2009

Sex

Female

Sole proprietor

No

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

Specialties & licenses 6

Addresses

Other identifiers 2

Other names 1

• Mary-Alice Rodstrom Other name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1238544000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1411948800000",
    "number": "1396987608",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1232 UNIVERSITY OF OREGON",
            "city": "EUGENE",
            "state": "OR",
            "postal_code": "974031205",
            "telephone_number": "541-346-2770",
            "fax_number": "541-346-2747"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1590 E. 13TH ST",
            "city": "EUGENE",
            "state": "OR",
            "postal_code": "974031232",
            "telephone_number": "541-346-2770",
            "fax_number": "541-346-2747"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ERNST",
        "first_name": "MARY-ALICE",
        "middle_name": "RODSTROM",
        "name_prefix": "Ms.",
        "credential": "A.N.P.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-04-01",
        "last_updated": "2014-09-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "OH",
            "license": "333339",
            "primary": false
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "KY",
            "license": "1119712",
            "primary": false
        },
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "OH",
            "license": "10367",
            "primary": false
        },
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "OH",
            "license": "333339-COA1",
            "primary": false
        },
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "OR",
            "license": "201050211NP",
            "primary": true
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "KY",
            "license": "6004P",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HUMANA",
            "identifier": "000019886Q",
            "state": "KY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM",
            "identifier": "000000624383",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MARY-ALICE",
            "last_name": "RODSTROM",
            "credential": "A.N.P.",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Daniel James Erickson, DDS
• Donald Allen Erickson, MA, LPC
• Laurie Ann Erickson, T.H.W & M.A.I.S.
• Robin Dell Erickson, ND, LMT
• Justin Ericson
• Maria Erskine, LMT
• Emmy Escanlar
• Tristen Rodriguez Escano, DPT
• Cecilia Escobedo
• Patricia Escoboza Choy

• Adult Health Nurse Practitioner in Eugene, OR
• Providers in Eugene, OR by specialty
• Adult Health Nurse Practitioner in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 29, 2014; 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.