Jacob L Erickson, DO

Primary specialty

Sports Medicine (Family Medicine) PhysicianTaxonomy code 207QS0010X

License

64193 Issued in WI

Practice address

191 Theater Rd
Onalaska, WI 54650

Phone

(608) 785-0940

NPI assigned

Jun 17, 2011

Last updated

Jun 15, 2022By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in WI

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Sports Medicine

Education

At Still University of Health Sciences, College of Osteo Med, Kirksville, 2011

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Mayo Clinic Health System-Southwest Wisconsin Region IncGroup PAC ID 0345152443, 539 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Mayo Clinic Health System-Franciscan Medical Center Inc Hospital, La Crosse, WI, CCN 520004
• Mayo Clinic HLTH Systm Franciscan Hlthcare Sparta Hospital, Sparta, WI, CCN 521305

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

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.

• Mayo Clinic Health System-Southwest Wisconsin Region, Inc.

  dba Mayo Clinic Health System - La Crosse

  • Multi-Specialty Clinic/Center
  • La Crosse, WI
  • NPI 1629056049
  Medicare reassignment Care Compare group NPD
• Mayo Clinic Health System-Southwest Wisconsin Region, Inc.

  dba Franciscan Healthcare - Sparta

  • Rural Health Clinic/Center
  • Sparta, WI
  • NPI 1366420788
  NPD
• Mayo Clinic Health System-Southwest Wisconsin Region, Inc.

  dba Mayo Clinic Health System - La Crosse

  • Multi-Specialty Clinic/Center
  • La Crosse, WI
  • NPI 1942980917
  NPD
• Mayo Clinic Health System-Southwest Wisconsin Region, Inc.

  dba Franciscan Healthcare - La Crosse

  • General Acute Care Hospital
  • La Crosse, WI
  • NPI 1801874227
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Mayo Clinic Health System-Southwest Wisconsin Region, Inc.

  dba Franciscan Healthcare - La Crosse

  • General Acute Care Hospital
  • La Crosse, WI
  • NPI 1801874227
  Care Compare affiliation
• Mayo Clinic Health System-Southwest Wisconsin Region, Inc.

  dba Franciscan Healthcare - Sparta

  • Critical Access Hospital
  • Sparta, WI
  • NPI 1841278637
  Care Compare affiliation
• Mayo Clinic Health System-Southwest Wisconsin Region, Inc.

  dba Mayo Clinic Health System - Arcadia

  • Rural Health Clinic/Center
  • Arcadia, WI
  • NPI 1972091361

  Hospital

  Care Compare affiliation

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

{
    "created_epoch": "1308268800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1655251200000",
    "number": "1861787814",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 1ST ST SW",
            "city": "ROCHESTER",
            "state": "MN",
            "postal_code": "559050001",
            "telephone_number": "608-785-0940"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "191 THEATER RD",
            "city": "ONALASKA",
            "state": "WI",
            "postal_code": "54650",
            "telephone_number": "608-785-0940"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "200 Hawkins Dr",
            "address_2": "Dept Family/Sports Medicine",
            "address_purpose": "LOCATION",
            "city": "Iowa City",
            "state": "IA",
            "postal_code": "522421009",
            "country_code": "US",
            "telephone_number": "319-384-7000",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "200 Hawkins Dr",
            "address_2": "Dept Family/Sports Medicine",
            "address_purpose": "LOCATION",
            "city": "Iowa City",
            "state": "IA",
            "postal_code": "522421009",
            "country_code": "US",
            "telephone_number": "319-384-7000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ERICKSON",
        "first_name": "JACOB",
        "middle_name": "L",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-06-17",
        "last_updated": "2022-06-15",
        "certification_date": "2022-06-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MN",
            "license": "55271",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "WI",
            "license": "64193",
            "primary": false
        },
        {
            "code": "207QS0010X",
            "taxonomy_group": "",
            "desc": "Family Medicine, Sports Medicine",
            "state": "WI",
            "license": "64193",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "jerickson25928@ehrdirect.mayoclinicmsg.org",
            "affiliation": "N",
            "address_1": "191 Theater Rd",
            "city": "Onalaska",
            "state": "WI",
            "country_code": "US",
            "postal_code": "54650",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Eclectic Counseling
• Janis Lorraine Elder, LPC
• Endodontic Specialists of Lacrosse LTD
• Katherine Eppolito, DMD
• Ivy L Erickson, PA-C
• Joel D Erickson, MD
• Mary C. Erickson, RPH
• Nancy L Erickson, MD
• Benjamin W Erlandson, D.C.
• Expanding Hope Counseling Services, LLC

• Sports Medicine (Family Medicine) Physician in Onalaska, WI
• Providers in Onalaska, WI by specialty
• Sports Medicine (Family Medicine) Physician in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 15, 2022; 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.
• 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.