Tracey L Erickson, PT
Individual provider Active NPI Physical Therapist · Edgewood, NM
NPI 1669550604 · NPPES record last updated Mar 17, 2025
Key facts
- NPI
- 1669550604
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Physical Therapist 225100000X
- License
- PT-2023-2218 (NM)
- Practice address
- 110 State Hwy 344
Edgewood, NM 87015 - Phone
- (505) 431-3822
- Fax
- (505) 431-3773
- NPI assigned
- Nov 1, 2006
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 2
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PT-2023-2218 | NM | MD | Physical Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Outpatient Physical Therapy & Sports Rehabilitation Inc PC | Physical Therapist | Past | Accepting new patients |
| Performance Sports and Spine Physical Therapy PS | Physical Therapist | Past | Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | PT-2023-2218 | NM | Yes |
Addresses
Primary practice location
110 State Hwy 344
Edgewood, NM 87015
Mailing address
PO Box 1780
Edgewood, NM 87015
Phone (505) 431-3822
Other providers in Edgewood, NM
- Cierra Dorado
- East Mountain Eye Clinic PC
- Edgewood Family Dentistry
- Edgewood Pediatric Clinic L.L.C.
- Amber Eichstedt
- Colleen Eungard
- Laci Fachini
- First Choice Community Healthcare, Inc.
- Fowler Enterprises, Inc.
- Debra Danielle Fromer
All providers in Edgewood, NM · Physical Therapist in New Mexico
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Mar 17, 2025. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.