Active NPI
Carmen Marie Ericson
- Family Nurse Practitioner
- New Castle, PA
National Provider Identifier
1790243731
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Nurse Practitioner
- License
- SP019636
- Practice address
- 1750 New Butler Rd Ste C
New Castle, PA 16101-3184 - Phone
- (724) 598-6080
- NPI assigned
- Mar 8, 2019
- Sex
- Female
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Family Nurse Practitioner | 363LF0000X | SP019636 | PA | Primary |
Addresses
Primary practice location
1750 New Butler Rd Ste C
New Castle, PA 16101-3184
Mailing address
107 Stonefield Dr
Cranberry Township, PA 16066-3333
Phone (412) 378-4514
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in PA
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: No
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20210315001788 | PA | Order and Referring Only - Nurse Practitioner | 2163838293 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| SP019636 | PA | MD | Family Nurse Practitioner |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1552003200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1552003200000",
"number": "1790243731",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "107 STONEFIELD DR",
"city": "CRANBERRY TOWNSHIP",
"state": "PA",
"postal_code": "160663333",
"telephone_number": "412-378-4514"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1750 NEW BUTLER RD STE C",
"city": "NEW CASTLE",
"state": "PA",
"postal_code": "161013184",
"telephone_number": "724-598-6080"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ERICSON",
"first_name": "CARMEN",
"middle_name": "MARIE",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2019-03-08",
"last_updated": "2019-03-08",
"status": "A"
},
"taxonomies": [
{
"code": "363LF0000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Family",
"state": "PA",
"license": "SP019636",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in New Castle, PA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 8, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.