Clinton S Anderson, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

1027 Issued in AK

Practice address

269 Morgan's Road
Aniak, AK 99557-0269

Phone

(907) 675-4556

Fax

(907) 675-4687

NPI assigned

Aug 22, 2006

Last updated

Mar 7, 2023By 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 2

Addresses

Medicare fee-for-service enrollment

Enrolled in UT

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Physician Assistant

Education

Other, 2006

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Catholic Health Initiatives ColoradoGroup PAC ID 8022927342, 1,230 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Holy Cross Hospital-Jordan Valley Hospital, West Jordan, UT, CCN 460051

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

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.

• Catholic Health Initiatives Colorado

  dba Behavioral Health West Valley

  • Prescribing (Medical) Psychologist
  • West Valley City, UT
  • NPI 1942903562
  Medicare reassignment Care Compare group
• Physician Group of Utah Inc

  • Specialist
  • South Jordan, UT
  • NPI 1477676930
  Medicare reassignment NPD
• Exodus Healthcare Network PLLC

  dba The Magna Center for Family Medicine

  • Family Medicine Physician
  • Magna, UT
  • NPI 1306952783
  Medicare reassignment
• Catholic Health Initiatives Colorado

  • Orthopaedic Surgery Physician
  • Murray, UT
  • NPI 1851083042
  NPD
• Catholic Health Initiatives Colorado

  dba CommonSpirit Orthopedics Longmont

  • Orthopaedic Surgery Physician
  • Longmont, CO
  • NPI 1891675294
  NPD
• Catholic Health Initiatives Colorado

  dba NSSH Neurosurg Sah

  • Neurological Surgery Physician
  • Lakewood, CO
  • NPI 1205846664
  NPD (past)

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

• Catholic Health Initiatives Colorado

  dba Holy Cross Hospital - Jordan Valley

  • General Acute Care Hospital
  • West Jordan, UT
  • NPI 1801591391
  Care Compare affiliation

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

{
    "created_epoch": "1156204800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1678147200000",
    "number": "1003922790",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "269 MORGAN'S ROAD",
            "city": "ANIAK",
            "state": "AK",
            "postal_code": "995570269",
            "telephone_number": "907-675-4556",
            "fax_number": "907-675-4687"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "269 MORGAN'S ROAD",
            "city": "ANIAK",
            "state": "AK",
            "postal_code": "995570269",
            "telephone_number": "907-675-4556",
            "fax_number": "907-675-4687"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ANDERSON",
        "first_name": "CLINTON",
        "middle_name": "S",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-22",
        "last_updated": "2023-03-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "UT",
            "license": "375970-1206",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "AK",
            "license": "1027",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Aniak Volunteer Fire Department
• Roberta Felica Downey, MFT
• Lisa Carmel Feyereisen
• Ken Hewitt, RPH
• Randy Hoeldt

• Physician Assistant in Aniak, AK
• Providers in Aniak, AK by specialty
• Physician Assistant in Alaska

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 2023; 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.