Larry E Anderson, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

5601001421 Issued in MI

Practice address

2840 Crooks Rd
Suite 111
Rochester Hills, MI 48309-3619

Phone

(248) 852-9290

Fax

(248) 852-0305

NPI assigned

Jun 5, 2006

Last updated

Aug 31, 2007By 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 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

Practice roles

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.

• Rochester Hills Health Services

  • Internal Medicine Physician
  • Rochester Hills, MI
  • NPI 1588799100
  NPD (past)
• Rochester Hills Medical Center P.C.

  • Emergency Medicine Physician
  • Rochester Hills, MI
  • NPI 1700094687
  NPD (past)

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

{
    "created_epoch": "1149465600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1188518400000",
    "number": "1023057056",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2840 CROOKS RD",
            "address_2": "SUITE 111",
            "city": "ROCHESTER HILLS",
            "state": "MI",
            "postal_code": "483093619",
            "telephone_number": "248-852-9290",
            "fax_number": "248-852-0305"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2840 CROOKS RD",
            "address_2": "SUITE 111",
            "city": "ROCHESTER HILLS",
            "state": "MI",
            "postal_code": "483093619",
            "telephone_number": "248-852-9290",
            "fax_number": "248-852-0305"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ANDERSON",
        "first_name": "LARRY",
        "middle_name": "E",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-05",
        "last_updated": "2007-08-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MI",
            "license": "5601001421",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PA LICENSE",
            "identifier": "5601001421",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Linda Andersen, RN
• Cynitra Tinika Anderson
• Heather Anderson, CNM
• Jennifer Anderson
• Jennifer Marie Anderson, FNP
• Andrew Ciarlone, DO PLLC
• Andrew J. Madak, D.O., P.C.
• Alison Sara Koo Andrus-Galliway, MA
• Angel Direct Homecare, LLC
• Angel Healthcare Express

• Physician Assistant in Rochester Hills, MI
• Providers in Rochester Hills, MI by specialty
• Physician Assistant in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 31, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.