Active NPI
Bethany Ericson
- Speech-Language Pathologist
- Dallas, TX
National Provider Identifier
1558739011
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Speech-Language Pathologist
- License
- 7452
- Practice address
- 9441 LBJ Fwy
Suite 602
Dallas, TX 75243-4545 - Phone
- (469) 249-1883
- NPI assigned
- Sep 14, 2015
- Last updated
- Sep 14, 2015
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Speech-Language Pathologist | 235Z00000X | 7452 | LA | Primary |
Addresses
Primary practice location
9441 LBJ Fwy
Suite 602
Dallas, TX 75243-4545
Mailing address
9441 LBJ Fwy
Suite 602
Dallas, TX 75243-4545
Phone (469) 249-1883
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
| License | State | Type | Specialty |
|---|---|---|---|
| 7452 | LA | MD | Speech-Language Pathologist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Supplemental Health Care | Past | Accepting new patients |
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.
-
- Sonography Radiologic Technologist
- Dallas, TX
- NPI 1770986762
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1442188800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1442188800000",
"number": "1558739011",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "9441 LBJ FWY",
"address_2": "SUITE 602",
"city": "DALLAS",
"state": "TX",
"postal_code": "752434545",
"telephone_number": "469-249-1883",
"fax_number": "877-788-7505"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "9441 LBJ FWY",
"address_2": "SUITE 602",
"city": "DALLAS",
"state": "TX",
"postal_code": "752434545",
"telephone_number": "469-249-1883"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ERICSON",
"first_name": "BETHANY",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2015-09-14",
"last_updated": "2015-09-14",
"status": "A"
},
"taxonomies": [
{
"code": "235Z00000X",
"taxonomy_group": "",
"desc": "Speech-Language Pathologist",
"state": "LA",
"license": "7452",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Dallas, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 14, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.