Individual provider Active NPI

Elizabeth Ann Erickson, M.D.

  • Family Medicine Physician
  • Colorado Springs, CO
National Provider Identifier
1619964830
Registry record updated May 15, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
36216 Issued in CO
Practice address
6615 Delmonico Dr
Colorado Springs, CO 80919-1809
Phone
(719) 364-9494
Fax
(719) 364-9761
NPI assigned
Oct 3, 2005
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 15, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 36216 CO Primary

Addresses

Primary practice location

6615 Delmonico Dr
Colorado Springs, CO 80919-1809

Mailing address

3141 Centennial Blvd
Colorado Springs, CO 80907-4094
Phone (303) 399-8020

Other identifiers 1

IdentifierTypeStateIssuer
01362169MedicaidCO

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CO
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240522000594 CO Order and Referring Only - Family PracticePractitioner - Family Practice 6901791953

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
36216COMDFamily Medicine Physician

NPI Registry JSON

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

{
    "created_epoch": "1128297600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1715731200000",
    "number": "1619964830",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3141 CENTENNIAL BLVD",
            "city": "COLORADO SPRINGS",
            "state": "CO",
            "postal_code": "809074094",
            "telephone_number": "303-399-8020"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6615 DELMONICO DR",
            "city": "COLORADO SPRINGS",
            "state": "CO",
            "postal_code": "809191809",
            "telephone_number": "719-364-9494",
            "fax_number": "719-364-9761"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ERICKSON",
        "first_name": "ELIZABETH",
        "middle_name": "ANN",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-10-03",
        "last_updated": "2024-05-15",
        "certification_date": "2024-05-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CO",
            "license": "36216",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01362169",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Colorado Springs, CO

Sources for this page

Verify at the official NPI Registry.