Active NPI
Scott Robert Ericson, ED.D.
- Psychologist
- Brentwood, TN
National Provider Identifier
1730263310
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychologist
- License
- P2088
- Practice address
- 205 Powell PL Ste 232
Brentwood, TN 37027-7522 - Phone
- (615) 963-0104
- NPI assigned
- Oct 24, 2006
- Sex
- Male
- 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 |
|---|---|---|---|---|
| Psychologist | 103T00000X | P2088 | TN | Primary |
Addresses
Primary practice location
205 Powell PL Ste 232
Brentwood, TN 37027-7522
Mailing address
4617 General Lowrey Dr
Nashville, TN 37215-4313
Phone (615) 298-4639
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 |
|---|---|---|---|
| P2088 | TN | MD | Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1161648000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1620864000000",
"number": "1730263310",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4617 GENERAL LOWREY DR",
"city": "NASHVILLE",
"state": "TN",
"postal_code": "372154313",
"telephone_number": "615-298-4639"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "205 POWELL PL STE 232",
"city": "BRENTWOOD",
"state": "TN",
"postal_code": "370277522",
"telephone_number": "615-963-0104"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ERICSON",
"first_name": "SCOTT",
"middle_name": "ROBERT",
"name_prefix": "Dr.",
"credential": "ED.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-10-24",
"last_updated": "2021-05-13",
"certification_date": "2021-05-13",
"status": "A"
},
"taxonomies": [
{
"code": "103T00000X",
"taxonomy_group": "",
"desc": "Psychologist",
"state": "TN",
"license": "P2088",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Brentwood, TN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 13, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.