Nana Ericsson, M.D.

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

11476 Issued in NV

Practice address

3540 W Sahara Ave
330
Las Vegas, NV 89102-5816

Phone

(702) 921-6823

Fax

(702) 921-6821

NPI assigned

May 3, 2006

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• East Texas Community Health Services, Inc

  • Community/Retail Pharmacy
  • Nacogdoches, TX
  • NPI 1457216665
  NPD (past)
• East Texas Community Health Services, Inc.

  • Federally Qualified Health Center (FQHC)
  • Nacogdoches, TX
  • NPI 1255367090
  NPD (past)

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

{
    "created_epoch": "1146614400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1297728000000",
    "number": "1508824913",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2600 S RAINBOW BLVD",
            "address_2": "108",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891464006",
            "telephone_number": "702-921-6823",
            "fax_number": "702-921-6821"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3540 W SAHARA AVE",
            "address_2": "330",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891025816",
            "telephone_number": "702-921-6823",
            "fax_number": "702-921-6821"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ERICSSON",
        "first_name": "NANA",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-05-03",
        "last_updated": "2011-02-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NV",
            "license": "11476",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100507057",
            "state": "NV"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Kjersten Erickson
• Margaret Erickson, RN
• Robert Anthony Erickson, CRNA
• Shonna Laraine Erickson, MFT, LADC
• Chanel Ericsson, MD
• Erika Kimble PLLC
• Erika Montes
• Allen Alva Erisman, D.O.
• Paulette Erkenbrack
• Edson Erkulvrawatr, M.D.

• Internal Medicine Physician in Las Vegas, NV
• Providers in Las Vegas, NV by specialty
• Internal Medicine Physician in Nevada

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 15, 2011; 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.