Vern E Erickson MD PA

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

Legal business name

VERN E ERICKSON MD PA

Practice address

205 7TH St W
Park Rapids, MN 56470-1545

Phone

(218) 732-7760

Fax

(218) 732-7334

NPI assigned

Aug 11, 2006

Organization subpart

No

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

Authorized official

Name

Dr. Vern E EricksonNPI 1760595979

Title

Owner

Phone

(218) 732-7760

Specialties & licenses 1

Addresses

Other identifiers 2

Other names 1

• ERICKSON MEDICAL CLINIC Doing business as

Medicare fee-for-service enrollment

Enrolled in MN

Enrollment records 1

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Locations

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Vern Erickson, M.D.

  • Internal Medicine Physician
  • Park Rapids, MN
  • NPI 1760595979

  Internal Medicine, MN

  Medicare reassignment NPD Authorized official
• Jessica Krauth, APRN,CNP, DNP

  • Psychiatric/Mental Health Nurse Practitioner
  • Breckenridge, MN
  • NPI 1851774905

  MN

  Medicare reassignment

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

{
    "created_epoch": "1155254400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1213315200000",
    "number": "1528070513",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3920 13TH AVE E",
            "address_2": "SUITE 6",
            "city": "HIBBING",
            "state": "MN",
            "postal_code": "557463675",
            "telephone_number": "218-263-7540",
            "fax_number": "866-732-0699"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "205 7TH ST W",
            "city": "PARK RAPIDS",
            "state": "MN",
            "postal_code": "564701545",
            "telephone_number": "218-732-7760",
            "fax_number": "218-732-7334"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VERN E ERICKSON MD PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-11",
        "last_updated": "2008-06-13",
        "status": "A",
        "authorized_official_last_name": "ERICKSON",
        "authorized_official_first_name": "VERN",
        "authorized_official_middle_name": "E",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "218-732-7760",
        "authorized_official_name_prefix": "Dr."
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "120354100",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "82065ER",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "ERICKSON MEDICAL CLINIC",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Craig Turnow, DPT
• United Security & Alarm Systems, Inc.
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• Upper Mississippi Mental Health Center, Inc.
• Vacationland Service Corporation, Inc
• Michael L Vettel, RPH
• Katherine Vichorek, NP
• Paula Marie Vigen
• Dawn Vosberg
• Robert Wahl, PTA

• All providers in Park Rapids, MN
• Internal Medicine Physician in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 13, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• 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.