Samira B Anderson, AUD
Individual provider Active NPI Audiologist · Faribault, MN
NPI 1023070372 · NPPES record last updated Jul 13, 2026
Key facts
- NPI
- 1023070372
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Audiologist 231H00000X
- License
- 5079 (MN)
- Practice address
- 100 State Ave
Faribault, MN 55021-6337 - Phone
- (507) 334-3921
- Fax
- (507) 332-5297
- NPI assigned
- Apr 3, 2006
- Sex
- Female
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 5079 | MN | MD | Audiologist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Audiologist | 231H00000X | 5079 | MN | Yes |
Addresses
Primary practice location
100 State Ave
Faribault, MN 55021-6337
Mailing address
PO Box 43
Mr 10809
Minneapolis, MN 55440-0043
Phone (612) 262-4813
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| SP | Medicaid | MN |
Other providers in Faribault, MN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 13, 2026. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.