David Alan Erickson, MD

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

ME152070 Issued in FL

Practice address

1005 Mar Walt Dr
Fort Walton Beach, FL 32547-6707

Phone

(850) 863-8203

Fax

(850) 863-8113

NPI assigned

Oct 15, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in FL

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: david.erickson.1@21123.direct.athenahealth.com

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• White-Wilson Medical Center PA

  • Clinic/Center
  • Fort Walton Beach, FL
  • NPI 1467437277
  Medicare reassignment NPD
• WW Medical Center, PA

  • Clinic/Center
  • Fort Walton Beach, FL
  • NPI 1225981707
  Medicare reassignment

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

{
    "created_epoch": "1160870400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1632182400000",
    "number": "1942390232",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1005 MAR WALT DR",
            "city": "FORT WALTON BEACH",
            "state": "FL",
            "postal_code": "325476707",
            "telephone_number": "850-863-8150",
            "fax_number": "850-863-4152"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1005 MAR WALT DR",
            "city": "FORT WALTON BEACH",
            "state": "FL",
            "postal_code": "325476707",
            "telephone_number": "850-863-8203",
            "fax_number": "850-863-8113"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ERICKSON",
        "first_name": "DAVID",
        "middle_name": "ALAN",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-15",
        "last_updated": "2021-09-21",
        "certification_date": "2021-09-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "FL",
            "license": "ME152070",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "111509700",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Zadie Mae Engelberger, PA
• Ryann Vanessa Ennis, SPEECH/LANGUAGE PATH
• Tara Rexanne Ennis, MD
• Epifani LLC
• Sara Kelly Erdwins, PA-C
• Samantha Ervin, APRN
• Tracie Esmond, LCSW
• Amy C Espy, MS,CCC-SLP
• Joseph J Esquibel, MD
• Everest Healthcare Inc

• Pediatrics Physician in Fort Walton Beach, FL
• Providers in Fort Walton Beach, FL by specialty
• Pediatrics Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 21, 2021; 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.

Verify at the official NPI Registry.