Individual provider Active NPI

Laura E Metzger, M.D.

  • Allergy & Immunology Physician
  • Salem, OR
National Provider Identifier
1770521833
Registry record updated Jun 12, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Allergy & Immunology PhysicianTaxonomy code 207K00000X
License
MD052618 Issued in OR
Practice address
2020 Capitol St NE
Salem, OR 97303-3244
Phone
(503) 399-2424
Fax
(503) 375-7429
NPI assigned
Jun 2, 2006
Last updated
Jun 12, 2016By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 12, 2016

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Allergy & Immunology Physician 207K00000X MD052618 OR Primary

Addresses

Primary practice location

2020 Capitol St NE
Salem, OR 97303-3244

Mailing address

9735 SW Shady LN
Ste 102
Tigard, OR 97223-5481
Phone (503) 620-5614

Other identifiers 3

IdentifierTypeStateIssuer
052618MedicaidOR
CS4159OtherRAILRAOD GROUP
030002156OtherORRAILROAD MEDICARE

Other names 1

  • Laura E Erickson Former name

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
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
MD052618ORMDAllergy & Immunology Physician

NPI Registry JSON

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

{
    "created_epoch": "1149206400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1465689600000",
    "number": "1770521833",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9735 SW SHADY LN",
            "address_2": "STE 102",
            "city": "TIGARD",
            "state": "OR",
            "postal_code": "972235481",
            "telephone_number": "503-620-5614",
            "fax_number": "503-598-4688"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2020 CAPITOL ST NE",
            "city": "SALEM",
            "state": "OR",
            "postal_code": "973033244",
            "telephone_number": "503-399-2424",
            "fax_number": "503-375-7429"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "METZGER",
        "first_name": "LAURA",
        "middle_name": "E",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-06-02",
        "last_updated": "2016-06-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207K00000X",
            "taxonomy_group": "",
            "desc": "Allergy & Immunology",
            "state": "OR",
            "license": "MD052618",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "052618",
            "state": "OR"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILRAOD GROUP",
            "identifier": "CS4159",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "030002156",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "LAURA",
            "last_name": "ERICKSON",
            "middle_name": "E",
            "credential": "M.D.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Salem, OR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 12, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.