Active NPI
Heather J. Erickson, O.D.
- Optometrist
- Wasilla, AK
National Provider Identifier
1669511200
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Optometrist
- License
- 197
- Practice address
- 3719 E Meridian Loop
Ste. C
Wasilla, AK 99654-7270 - Phone
- (907) 357-9595
- Fax
- (907) 357-9575
- NPI assigned
- Feb 6, 2007
- 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 |
|---|---|---|---|---|
| Optometrist | 152W00000X | 197 | AK | Primary |
Addresses
Primary practice location
3719 E Meridian Loop
Ste. C
Wasilla, AK 99654-7270
Mailing address
3719 E Meridian Loop
Ste. C
Wasilla, AK 99654-7270
Phone (907) 357-9595
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| OD78741 | Medicaid | AK |
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)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 197 | AK | MD | Speech-Language Pathologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1170720000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183939200000",
"number": "1669511200",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3719 E MERIDIAN LOOP",
"address_2": "STE. C",
"city": "WASILLA",
"state": "AK",
"postal_code": "996547270",
"telephone_number": "907-357-9595",
"fax_number": "907-357-9575"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3719 E MERIDIAN LOOP",
"address_2": "STE. C",
"city": "WASILLA",
"state": "AK",
"postal_code": "996547270",
"telephone_number": "907-357-9595",
"fax_number": "907-357-9575"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ERICKSON",
"first_name": "HEATHER",
"middle_name": "J.",
"credential": "O.D.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2007-02-06",
"last_updated": "2007-07-09",
"status": "A"
},
"taxonomies": [
{
"code": "152W00000X",
"taxonomy_group": "",
"desc": "Optometrist",
"state": "AK",
"license": "197",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "OD78741",
"state": "AK"
}
],
"endpoints": [],
"other_names": []
}Other providers in Wasilla, AK
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.