Individual provider Active NPI

Robert Michael Anderson, M.D.

  • Emergency Medicine Physician
  • Lake Charles, LA
National Provider Identifier
1013094416
Registry record updated Sep 29, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
19984 Issued in LA
Practice address
1701 Oak Park Blvd
Lake Charles, LA 70601-8911
Phone
(337) 494-2086
Fax
(337) 430-6983
NPI assigned
Nov 1, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 29, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X 19984 LA Primary

Addresses

Primary practice location

1701 Oak Park Blvd
Lake Charles, LA 70601-8911

Mailing address

4446 Prien Terre Dr
Lake Charles, LA 70605-3932
Phone (337) 494-2086

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in LA
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20031122000060 LA Practitioner - Emergency Medicine 3971417247 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
HHS exclusion list flag
Flagged The directory lists this NPI on an HHS exclusion list. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
19984LAMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Calcasieu Urgent Care LLC CurrentSince Dec 1, 2012 Accepting new patients
Calcasieu Images LLC Current Accepting new patients
Calcasieu Urgent Care, LLC CurrentSince May 4, 2012 Accepting new patients
Georgia Em-I Medical Services, LLC Emergency Medicine Past Accepting new patients
Emergency Medicine Specialist, Apmc Emergency Medicine Past Accepting new patients

Locations

2640 Country Club Rd
Ste 400
Lake Charles, LA 70605
Phone (337) 426-0919

242 Sam Houston Jones Pkwy
Moss Bluff, LA 70611
Phone (337) 905-4000

307 Keyser Ave
Natchitoches, LA 71457
Phone (318) 352-5221

6550 Carothers Pkwy
Ste 225
Franklin, TN 37067

Organizations & group practices 5

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.

NPI Registry JSON

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

{
    "created_epoch": "1162339200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1317254400000",
    "number": "1013094416",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4446 PRIEN TERRE DR",
            "city": "LAKE CHARLES",
            "state": "LA",
            "postal_code": "706053932",
            "telephone_number": "337-494-2086",
            "fax_number": "337-430-6983"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1701 OAK PARK BLVD",
            "city": "LAKE CHARLES",
            "state": "LA",
            "postal_code": "706018911",
            "telephone_number": "337-494-2086",
            "fax_number": "337-430-6983"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ANDERSON",
        "first_name": "ROBERT",
        "middle_name": "MICHAEL",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-11-01",
        "last_updated": "2011-09-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "LA",
            "license": "19984",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lake Charles, LA

Sources for this page

Verify at the official NPI Registry.