Active NPI
Carly Mae Johnson Erickson, ND
- Naturopath
- Alexandria, MN
National Provider Identifier
1629486246
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Naturopath
- License
- 1057
- Practice address
- 503 Hawthorne St Ste 145
Alexandria, MN 56308-1991 - Phone
- (320) 200-1477
- NPI assigned
- Jul 28, 2014
- Last updated
- Sep 26, 2019
- Sex
- Female
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Naturopath | 175F00000X | 1057 | MN | Primary |
Addresses
Primary practice location
503 Hawthorne St Ste 145
Alexandria, MN 56308-1991
Mailing address
1807 Woodland Park Dr NE
Alexandria, MN 56308-8584
Phone (320) 200-1477
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 |
|---|---|---|---|
| 1057 | MN | MD | Naturopath |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1406505600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1569456000000",
"number": "1629486246",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1807 WOODLAND PARK DR NE",
"city": "ALEXANDRIA",
"state": "MN",
"postal_code": "563088584",
"telephone_number": "320-200-1477"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "503 HAWTHORNE ST STE 145",
"city": "ALEXANDRIA",
"state": "MN",
"postal_code": "563081991",
"telephone_number": "320-200-1477"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ERICKSON",
"first_name": "CARLY",
"middle_name": "MAE JOHNSON",
"credential": "ND",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2014-07-28",
"last_updated": "2019-09-26",
"status": "A"
},
"taxonomies": [
{
"code": "175F00000X",
"taxonomy_group": "",
"desc": "Naturopath",
"state": "MN",
"license": "1057",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Alexandria, MN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 26, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.