Jordan Lee Ericksen, AU.D.

Primary specialty

AudiologistTaxonomy code 231H00000X

License

01598 Issued in MD

Practice address

23 Crossroads Dr Ste 400
Owings Mills, MD 21117-5490

Phone

(410) 356-2626

NPI assigned

Apr 2, 2018

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in MD

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Annapolis ENT Surgical Center LLC

  • Specialist
  • Annapolis, MD
  • NPI 1275372617
  Medicare reassignment NPD
• Annapolis ENT Surgical Center, LLC

  • Ambulatory Surgical Clinic/Center
  • Annapolis, MD
  • NPI 1629094917
  NPD (past)

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

{
    "created_epoch": "1522627200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1693872000000",
    "number": "1629574462",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10002 PRINCESS PALM AVE STE 332",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336198327",
            "telephone_number": "813-571-7184",
            "fax_number": "813-654-4695"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "23 CROSSROADS DR STE 400",
            "city": "OWINGS MILLS",
            "state": "MD",
            "postal_code": "211175490",
            "telephone_number": "410-356-2626"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ERICKSEN",
        "first_name": "JORDAN",
        "middle_name": "LEE",
        "credential": "AU.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-04-02",
        "last_updated": "2023-09-05",
        "certification_date": "2023-09-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "231H00000X",
            "taxonomy_group": "",
            "desc": "Audiologist",
            "state": "FL",
            "license": "AY2173",
            "primary": false
        },
        {
            "code": "231H00000X",
            "taxonomy_group": "",
            "desc": "Audiologist",
            "state": "MD",
            "license": "01598",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Devyn Epps
• Tajae Sophia Epps
• Ralph Benjamin Epstein, M.D.
• Equilibrum Behavioral Health &T Elepsych
• Eric J Kraut MD LLC
• Erosun Behavioral Health Services Inc,
• Erosun Behavioral Health Services Inc,
• Erosun Behavioral Health Services Inc,
• Erosun Inc
• Melissa A Ervin

• Audiologist in Owings Mills, MD
• Providers in Owings Mills, MD by specialty
• Audiologist in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 5, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.