Nathan James Andersen, DC

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

5544-12 Issued in WI

Practice address

504 S. Yellowstone Lane
Madison, WI 53719

Phone

(847) 558-9155

NPI assigned

Jun 9, 2020

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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 and National Provider Directory roles.

• 360 Wellness LLC

  • Chiropractor
  • Madison, WI
  • NPI 1376168989
  NPD Authorized official

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

{
    "created_epoch": "1591660800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1591660800000",
    "number": "1023633757",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "504 S. YELLOWSTONE LANE",
            "city": "MADISON",
            "state": "WI",
            "postal_code": "53719"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "504 S. YELLOWSTONE LANE",
            "city": "MADISON",
            "state": "WI",
            "postal_code": "53719",
            "telephone_number": "847-558-9155"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ANDERSEN",
        "first_name": "NATHAN",
        "middle_name": "JAMES",
        "name_prefix": "Dr.",
        "credential": "DC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2020-06-09",
        "last_updated": "2020-06-09",
        "certification_date": "2020-06-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Chiropractor",
            "state": "WI",
            "license": "5544-12",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "Drandersen@360wellnesswi.com",
            "affiliation": "N",
            "endpointDescription": "Health Information Exchange",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "address_1": "504 S. Yellowstone Lane",
            "city": "Madison",
            "state": "WI",
            "country_code": "US",
            "postal_code": "53719",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Aaron Daniel Andersen
• Atalie Andersen, APNP
• James R Andersen, MD
• Kelsey Andersen, DPT
• Lucas Andersen, PA-C
• Nicole M Andersen, DDS
• Patrick C Andersen, D.C.
• William Andersen, MD
• Anderson & Shapiro Eye Surgeons, SC
• India Anise Anderson-Carter

• All providers in Madison, WI
• Chiropractor in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 9, 2020; 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.