Mary Erickson, ENP, FNP

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

E06230009 Issued in OR

Practice address

1253 NW Canal Blvd
Redmond, OR 97756-1334

Phone

(541) 213-8195

NPI assigned

Jun 21, 2023

Last updated

May 14, 2024By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in OR

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

Specialty

Nurse Practitioner

Education

Vanderbilt University School of Medicine, 2023

Medicare assignment

May accept Medicare assignment

Group practices

Asher Community Health CenterGroup PAC ID 2163460726, 5 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: merickson762082@direct.ochin.org

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.

• Asher Community Health Center

  dba Asher Clinic

  • Federally Qualified Health Center (FQHC)
  • Fossil, OR
  • NPI 1811937485
  Medicare reassignment Care Compare group NPD
• Asher Community Health Center

  • Primary Care Clinic/Center
  • Fossil, OR
  • NPI 1033989439
  NPD
• St. Charles Health System, Inc.

  dba St. Charles Bend

  • General Acute Care Hospital
  • Bend, OR
  • NPI 1982621447
  NPD
• St. Charles Health System, Inc.

  dba St. Charles Home Health

  • Home Health Agency
  • Madras, OR
  • NPI 1225226004
  NPD (past)
• St. Charles Health System, Inc.

  dba St. Charles Prineville

  • Critical Access Hospital
  • Prineville, OR
  • NPI 1710160445
  NPD (past)
• St. Charles Health System, Inc.

  dba St. Charles Behavioral Health

  • Clinical Social Worker
  • Bend, OR
  • NPI 1780698696
  NPD (past)

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

{
    "created_epoch": "1687305600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1715644800000",
    "number": "1417632852",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1253 NW CANAL BLVD",
            "city": "REDMOND",
            "state": "OR",
            "postal_code": "977561334",
            "telephone_number": "541-213-8195"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1253 NW CANAL BLVD",
            "city": "REDMOND",
            "state": "OR",
            "postal_code": "977561334",
            "telephone_number": "541-213-8195"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ERICKSON",
        "first_name": "MARY",
        "credential": "ENP, FNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-06-21",
        "last_updated": "2024-05-14",
        "certification_date": "2024-05-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "OR",
            "license": "E06230009",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Enhanced Physical Therapy and Wellness LLC
• Jake C. Epley
• Tana Eri
• Eric B. Hayden (Healthsource of Redmond)
• Larry M Erickson, HIS
• Thomas N Ernst, MD
• Kohleen E Ervin, RD, CSR, LD
• Matthew M Eschelbach, DO
• Leslie Estrada Burgos, BEHAVIOR TECHNICIAN
• Ethos Therapy Services LLC

• Nurse Practitioner in Redmond, OR
• Providers in Redmond, OR by specialty
• Nurse Practitioner in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 14, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.