Active NPI
Elise Irene Erickson, DPT
- Physical Therapist
- Golden Valley, MN
National Provider Identifier
1609155803
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 8855
- Practice address
- 3915 Golden Valley Rd
Golden Valley, MN 55422-4249 - Phone
- (763) 520-0654
- Fax
- (763) 520-0335
- NPI assigned
- Aug 5, 2011
- 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 |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 8855 | MN | Primary |
Addresses
Primary practice location
3915 Golden Valley Rd
Golden Valley, MN 55422-4249
Mailing address
3915 Golden Valley Rd
Golden Valley, MN 55422-4249
Phone (763) 520-0654
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 |
|---|---|---|---|
| 8855 | MN | MD | Pediatrics Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1312502400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1312502400000",
"number": "1609155803",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3915 GOLDEN VALLEY RD",
"city": "GOLDEN VALLEY",
"state": "MN",
"postal_code": "554224249",
"telephone_number": "763-520-0654",
"fax_number": "763-520-0335"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3915 GOLDEN VALLEY RD",
"city": "GOLDEN VALLEY",
"state": "MN",
"postal_code": "554224249",
"telephone_number": "763-520-0654",
"fax_number": "763-520-0335"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ERICKSON",
"first_name": "ELISE",
"middle_name": "IRENE",
"credential": "DPT",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2011-08-05",
"last_updated": "2011-08-05",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "MN",
"license": "8855",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Golden Valley, MN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 5, 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.