Individual provider Active NPI

Whitney Bolton Erickson, PMHNP, FNP

  • Nurse Practitioner
  • Memphis, TN
National Provider Identifier
1578995791
Registry record updated Jan 7, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
17813 Issued in TN
Practice address
6373 N Quail Hollow Rd Ste 101
Memphis, TN 38120-1405
Phone
(901) 871-0170
Fax
(901) 871-0353
NPI assigned
Jul 31, 2013
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 7, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 17813 TN
Nurse Practitioner 363L00000X 17813 TN Primary

Addresses

Primary practice location

6373 N Quail Hollow Rd Ste 101
Memphis, TN 38120-1405

Mailing address

6373 N Quail Hollow Rd
Memphis, TN 38120-1405
Phone (901) 871-0170

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TN
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20160121002560 TN Order and Referring Only - Nurse Practitioner 6305089632

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Interoperability endpoints

  • Direct secure messaging: whitney.erickson.1@32343.direct.athenahealth.com

NPI Registry JSON

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

{
    "created_epoch": "1375228800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1736208000000",
    "number": "1578995791",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6373 N QUAIL HOLLOW RD",
            "city": "MEMPHIS",
            "state": "TN",
            "postal_code": "381201405",
            "telephone_number": "901-871-0170",
            "fax_number": "901-871-0353"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6373 N QUAIL HOLLOW RD STE 101",
            "city": "MEMPHIS",
            "state": "TN",
            "postal_code": "381201405",
            "telephone_number": "901-871-0170",
            "fax_number": "901-871-0353"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ERICKSON",
        "first_name": "WHITNEY",
        "middle_name": "BOLTON",
        "name_prefix": "Mrs.",
        "credential": "PMHNP, FNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2013-07-31",
        "last_updated": "2025-01-07",
        "certification_date": "2025-01-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "TN",
            "license": "17813",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "TN",
            "license": "17813",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Memphis, TN

Sources for this page

Verify at the official NPI Registry.