Active NPI
Cheyanne Marie Andersen, LPTA
- Physical Medicine & Rehabilitation Physician
- Kingsland, GA
National Provider Identifier
1043127103
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Medicine & Rehabilitation Physician
- License
- 2306606915
- Practice address
- 1390 Boone Avenue Ext Ste 23
Kingsland, GA 31548-6516 - Phone
- (912) 319-0400
- NPI assigned
- Aug 25, 2026
- Last updated
- Aug 25, 2026
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Medicine & Rehabilitation Physician | 208100000X | 2306606915 | VA | Primary |
Addresses
Primary practice location
1390 Boone Avenue Ext Ste 23
Kingsland, GA 31548-6516
Mailing address
2143 Chesterfield Loop
Chesapeake, VA 23323-6663
Phone (757) 818-0910
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2306606915 | VA | MD | Physical Medicine & Rehabilitation Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1787616000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1787616000000",
"number": "1043127103",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2143 CHESTERFIELD LOOP",
"city": "CHESAPEAKE",
"state": "VA",
"postal_code": "233236663",
"telephone_number": "757-818-0910",
"fax_number": "757-818-0910"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1390 BOONE AVENUE EXT STE 23",
"city": "KINGSLAND",
"state": "GA",
"postal_code": "315486516",
"telephone_number": "912-319-0400"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ANDERSEN",
"first_name": "CHEYANNE",
"middle_name": "MARIE",
"credential": "LPTA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2026-08-25",
"last_updated": "2026-08-25",
"certification_date": "2026-08-25",
"status": "A"
},
"taxonomies": [
{
"code": "208100000X",
"taxonomy_group": "",
"desc": "Physical Medicine & Rehabilitation",
"state": "VA",
"license": "2306606915",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Kingsland, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 25, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.