JACK ERICKSON DC
NPI 1194438374
Chiropractor in Eagan, MN
About Jack Erickson Dc NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
JACK ERICKSON DC (NPI 1194438374) is an individual chiropractor in Eagan, Minnesota, licensed in Minnesota (7040) and active in the NPI registry since January 2023. He is a graduate of Northwestern College Of Chiropractic (2022).
NPPES Registry Identity
Specialties & Licenses
Medicare Participation & PECOS CMS
Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.
Medicare Enrollment Status
Enrolled in Medicare and accepts Medicare assignment
Jack Erickson Dc is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.
Medicare Billing Reassignment
Medicare enrollment records show Jack Erickson reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.
St Louis Park, MN 55416
- Reassigned Medicare billing, Minnesota enrollment
- 29 clinicians in this Medicare group
Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
Other Providers at the Same Location NPPES 3
Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.
Frequently Asked Questions NPPES & CMS
Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.
What is Jack Erickson's NPI number?
The NPI number for Jack Erickson is 1194438374. It was assigned to this individual provider in the NPPES registry on January 3, 2023.
Where is Jack Erickson located?
Jack Erickson practices at 1565 Thomas Center Dr, Eagan, MN 55122. The listed phone number is (651) 734-6959.
What is Jack Erickson's specialty?
The primary specialty registered for this NPI is Chiropractor with taxonomy code 111N00000X.
Is Jack Erickson enrolled in Medicare?
Yes. Jack Erickson is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.
Which organization bills Medicare for Jack Erickson's services?
According to the CMS Revalidation Reassignment List (October 2026 release), Jack Erickson reassigns Medicare benefits to Life Clinic, P.A. (St Louis Park, MN). The reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Jack Erickson's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.
When was this NPI record last updated?
The NPPES record for Jack Erickson was last updated on January 3, 2023. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.
# Jack Erickson, DC · NPI 1194438374
Chiropractor provider in Eagan, Minnesota. Individual provider, active in the CMS NPPES registry since January 3, 2023.
## Identity
- **NPI:** 1194438374 (Entity type: Individual)
- **Enumerated:** January 3, 2023
- **Primary specialty:** Chiropractor · taxonomy 111N00000X
- **State license:** 7040 (Minnesota)
- **Sole proprietor:** No
## Practice location
- **Address:** 1565 THOMAS CENTER DR, Eagan, MN 55122-2642
- **Phone:** (651) 734-6959
## Medicare
- **Medicare:** Enrolled (PECOS); accepts Medicare assignment
- **Bills Medicare through:** Life Clinic, P.A. (NPI 1023296167, St Louis Park, MN), under Medicare reassignment (form CMS-855R) · CMS Revalidation Reassignment List, October 2026 release
- **Medical school:** Northwestern College Of Chiropractic, class of 2022
## Record status
- **NPPES last updated:** January 3, 2023
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Source: [NPI Profile](https://npiprofile.com/npi/1194438374) · Data from the CMS NPPES public registry.