Nicole Lee Keck-Erickson, D.M.D.

Primary specialty

DentistTaxonomy code 122300000X

License

D9139 Issued in OR

Practice address

906 Royal CT
Medford, OR 97504-6139

Phone

(541) 779-2634

Fax

(541) 779-3282

NPI assigned

Sep 3, 2008

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Mrs. Nicole Lee Keck-Erickson Other name

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: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

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

{
    "created_epoch": "1220400000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1220400000000",
    "number": "1447408463",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "906 ROYAL CT",
            "city": "MEDFORD",
            "state": "OR",
            "postal_code": "975046139",
            "telephone_number": "541-779-2634",
            "fax_number": "541-779-3282"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "906 ROYAL CT",
            "city": "MEDFORD",
            "state": "OR",
            "postal_code": "975046139",
            "telephone_number": "541-779-2634",
            "fax_number": "541-779-3282"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KECK-ERICKSON",
        "first_name": "NICOLE",
        "middle_name": "LEE",
        "name_prefix": "Dr.",
        "credential": "D.M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-09-03",
        "last_updated": "2008-09-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "OR",
            "license": "D9139",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "NICOLE",
            "last_name": "KECK-ERICKSON",
            "middle_name": "LEE",
            "prefix": "MRS.",
            "credential": "D.M.D.",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Lori Anne Katzin Plumb, LMT
• Barbara J Kaylor, CNS
• Kuldeep KC, FNP-C
• John Cameron Kearns, MD
• Brent Robert Keate, MD
• Noah Keegan, PA
• Blake Keele, EMTB
• Nancy J. Keeley, FNP
• Ariel Keen
• Jade D Keglovitz, QMHA

• Dentist in Medford, OR
• Providers in Medford, OR by specialty
• Dentist in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 3, 2008; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.