Individual provider Active NPI

Charles E Erickson, HEARING AID SPECIALI

  • Hearing Instrument Specialist
  • Palm Desert, CA
National Provider Identifier
1437230653
Registry record updated Feb 12, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Hearing Instrument SpecialistTaxonomy code 237700000X
License
HA 7892 Issued in CA
Practice address
73131 Country Club Dr Ste C5
Palm Desert, CA 92260-2339
Phone
(760) 568-1300
Fax
(760) 568-1270
NPI assigned
Oct 17, 2006
Last updated
Feb 12, 2019By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 12, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Hearing Instrument Specialist 237700000X HA 7892 CA Primary

Addresses

Primary practice location

73131 Country Club Dr Ste C5
Palm Desert, CA 92260-2339

Mailing address

72880 Highway 111
Inside Sears
Palm Desert, CA 92260-3313
Phone (760) 568-1300

Other identifiers 1

IdentifierTypeStateIssuer
HA 7892OtherCACA-HEARING AID SPECIALI

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

LicenseStateTypeSpecialty
HA 7892CAMDHearing Instrument Specialist

Organizations & group practices 1

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": "1161043200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1549929600000",
    "number": "1437230653",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "72880 HIGHWAY 111",
            "address_2": "INSIDE SEARS",
            "city": "PALM DESERT",
            "state": "CA",
            "postal_code": "922603313",
            "telephone_number": "760-568-1300",
            "fax_number": "760-568-1270"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "73131 COUNTRY CLUB DR STE C5",
            "city": "PALM DESERT",
            "state": "CA",
            "postal_code": "922602339",
            "telephone_number": "760-568-1300",
            "fax_number": "760-568-1270"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ERICKSON",
        "first_name": "CHARLES",
        "middle_name": "E",
        "name_prefix": "Mr.",
        "credential": "HEARING AID SPECIALI",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-17",
        "last_updated": "2019-02-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "237700000X",
            "taxonomy_group": "",
            "desc": "Hearing Instrument Specialist",
            "state": "CA",
            "license": "HA 7892",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CA-HEARING AID SPECIALI",
            "identifier": "HA 7892",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Palm Desert, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 12, 2019; 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.