Bethany Ericson, RD, LD

Primary specialty

Registered DietitianTaxonomy code 133V00000X

License

LDD10158487 Issued in OR

Practice address

351 SW 9TH St
Ontario, OR 97914-2639

Phone

(208) 899-7933

NPI assigned

Dec 17, 2013

Sex

Female

Sole proprietor

Yes

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 ID

Enrollment records 1

Specialty

Registered Dietitian Or Nutrition Professional

Education

Other, 2012

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

St Lukes Clinic-Treasure Valley LLCGroup PAC ID 4981878402, 1,155 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• St Lukes Clinic-Treasure Valley LLC

  • Family Medicine Physician
  • Boise, ID
  • NPI 1326336058
  Medicare reassignment Care Compare group NPD
• St Lukes Regional Medical Center

  dba St Lukes Meridian Medical Center

  • General Acute Care Hospital
  • Boise, ID
  • NPI 1770586794
  NPD (past)

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

{
    "created_epoch": "1387238400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1565827200000",
    "number": "1710308804",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "351 SW 9TH ST",
            "city": "ONTARIO",
            "state": "OR",
            "postal_code": "979142639",
            "telephone_number": "208-899-7933"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "351 SW 9TH ST",
            "city": "ONTARIO",
            "state": "OR",
            "postal_code": "979142639",
            "telephone_number": "208-899-7933"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3325 Pocahontas Rd",
            "address_purpose": "LOCATION",
            "city": "Baker City",
            "state": "OR",
            "postal_code": "978141464",
            "country_code": "US",
            "telephone_number": "541-523-6461",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ERICSON",
        "first_name": "BETHANY",
        "credential": "RD, LD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2013-12-17",
        "last_updated": "2019-08-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "ID",
            "license": "D-778",
            "primary": false
        },
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "OR",
            "license": "LDD10158487",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Crystal Adriana Elguezabal
• Emeritol Meadowbrook LLC (Brookdale Ontario)
• Emeritus Corporation (Brookdale Ontario)
• Glenn Erhardt
• Eric N Dahle DMD PC
• Roberto Guillermo Escobedo
• Alexia Esquivel
• Brenda Marlen Estrada Figueroa
• Jamie Estrada
• Caitlin Jeanne Therese Evans, PA-S

• Registered Dietitian in Ontario, OR
• Providers in Ontario, OR by specialty
• Registered Dietitian in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 15, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.