Active NPI
Eric Marc Erlewine, MPT
- Community Health Worker
- Shreveport, LA
National Provider Identifier
1750605622
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Community Health Worker
- License
- 18982
- Practice address
- 7330 Fern Ave
Shreveport, LA 71105-4971 - Phone
- (304) 670-6965
- NPI assigned
- Mar 22, 2010
- Last updated
- Mar 22, 2010
- 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 |
|---|---|---|---|---|
| Community Health Worker | 172V00000X | 18982 | MA | Primary |
Addresses
Primary practice location
7330 Fern Ave
Shreveport, LA 71105-4971
Mailing address
101 Bradys Ridge Rd
Wellsburg, WV 26070-1901
Phone (304) 670-6965
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 |
|---|---|---|---|
| 18982 | MA | MD | Community Health Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1269216000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1269216000000",
"number": "1750605622",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "101 BRADYS RIDGE RD",
"city": "WELLSBURG",
"state": "WV",
"postal_code": "260701901",
"telephone_number": "304-670-6965"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "7330 FERN AVE",
"city": "SHREVEPORT",
"state": "LA",
"postal_code": "711054971",
"telephone_number": "304-670-6965"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ERLEWINE",
"first_name": "ERIC",
"middle_name": "MARC",
"name_prefix": "Mr.",
"credential": "MPT",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2010-03-22",
"last_updated": "2010-03-22",
"status": "A"
},
"taxonomies": [
{
"code": "172V00000X",
"taxonomy_group": "",
"desc": "Community Health Worker",
"state": "MA",
"license": "18982",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Shreveport, LA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 22, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.