Active NPI
David Jason Erickson I, L.M.T
- Massage Therapist
- Polson, MT
National Provider Identifier
1407255706
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Massage Therapist
- License
- 4008
- Practice address
- 36084 Caroline LN
Polson, MT 59860-8442 - Phone
- (406) 880-0568
- NPI assigned
- Aug 22, 2014
- Sex
- Male
- Sole proprietor
- Yes
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 | 4008 | MT | Primary |
Addresses
Primary practice location
36084 Caroline LN
Polson, MT 59860-8442
Mailing address
PO Box 304
Polson, MT 59860-0304
Phone (406) 880-0568
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 |
|---|---|---|---|
| 4008 | MT | MD | Massage Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1408665600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1408665600000",
"number": "1407255706",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 304",
"city": "POLSON",
"state": "MT",
"postal_code": "598600304",
"telephone_number": "406-880-0568"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "36084 CAROLINE LN",
"city": "POLSON",
"state": "MT",
"postal_code": "598608442",
"telephone_number": "406-880-0568"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ERICKSON",
"first_name": "DAVID",
"middle_name": "JASON",
"name_suffix": "I",
"credential": "L.M.T",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2014-08-22",
"last_updated": "2014-08-22",
"status": "A"
},
"taxonomies": [
{
"code": "225700000X",
"taxonomy_group": "",
"desc": "Massage Therapist",
"state": "MT",
"license": "4008",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Polson, MT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 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.