C James Anderson DPM LLC

Organization Active NPI Foot & Ankle Surgery Podiatrist · Columbia, IL

NPI 1033738547 · NPPES record last updated Apr 14, 2020

Key facts

NPI
1033738547
Entity type
Organization (NPI type 2)
Primary specialty
Foot & Ankle Surgery Podiatrist 213ES0103X
Legal business name
C JAMES ANDERSON DPM LLC
Practice address
1000 Eleven S Ste 3a
Columbia, IL 62236-1077
Phone
(618) 277-9533
NPI assigned
Apr 14, 2020
Organization subpart
No

Authorized official

Name
Melissa Bauer
Title
Billing Dept
Phone
(618) 277-7087

Other NPIs with the same Medicare PAC ID 2

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

Corporate family (same tax ID) 2

Organizations that report the same tax identification number in the National Provider Directory.

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

Medicare participation

Medicare fee-for-service enrollment
Enrolled in IL

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
O20200427001039 IL DME Supplier - Physician - Podiatry 2961652979 Practice locations: Columbia, IL

National Provider Directory

Tax ID family
C James Anderson DPM LLC (3 organizations share this tax ID)

Locations

1000 Eleven S
Ste 3A
Columbia, IL 62236
Phone (618) 277-9533

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Foot & Ankle Surgery Podiatrist
Group: 193400000X SINGLE SPECIALTY GROUP
213ES0103X Yes

Addresses

Primary practice location

1000 Eleven S Ste 3a
Columbia, IL 62236-1077

Mailing address

PO Box 3681
Springfield, IL 62708-3681
Phone (618) 277-9533

Other providers in Columbia, IL

All providers in Columbia, IL · Foot & Ankle Surgery Podiatrist in Illinois

Sources for this page

Verify at the official NPI Registry.