Peter Corless Anderson, M.D.

Primary specialty

Otolaryngology PhysicianTaxonomy code 207Y00000X

License

5366856-1205 Issued in UT

Practice address

3584 W 9000 S
Ste. 311
West Jordan, UT 84088-5710

Phone

(801) 566-8304

NPI assigned

May 12, 2009

Last updated

Jun 23, 2015By the provider in NPPES

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

Medicare fee-for-service enrollment

Enrolled in UT

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Otolaryngology

Education

Saint Louis University School of Medicine, 2009

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

South Valley Ear Nose and Throat Associates PLLCGroup PAC ID 9335125855, 10 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Holy Cross Hospital-Jordan Valley Hospital, West Jordan, UT, CCN 460051
• Intermountain Health Riverton Hospital Hospital, Riverton, UT, CCN 460058

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: southvalleyent.peteranderson@153057.advancedmd-direct.com

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.

• South Valley Ear Nose and Throat Associates, PLLC

  • Otolaryngology Physician
  • West Jordan, UT
  • NPI 1508926551
  Medicare reassignment Care Compare group NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Catholic Health Initiatives Colorado

  dba Holy Cross Hospital - Jordan Valley

  • General Acute Care Hospital
  • West Jordan, UT
  • NPI 1801591391
  Care Compare affiliation
• Ihc Health Services Inc

  dba Intermountain Health Riverton Hospital

  • General Acute Care Hospital
  • Riverton, UT
  • NPI 1154551919
  Care Compare affiliation

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

{
    "created_epoch": "1242086400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1435017600000",
    "number": "1043444516",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3584 W 9000 S",
            "address_2": "STE. 311",
            "city": "WEST JORDAN",
            "state": "UT",
            "postal_code": "840885710",
            "telephone_number": "801-566-8304"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3584 W 9000 S",
            "address_2": "STE. 311",
            "city": "WEST JORDAN",
            "state": "UT",
            "postal_code": "840885710",
            "telephone_number": "801-566-8304"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ANDERSON",
        "first_name": "PETER",
        "middle_name": "CORLESS",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2009-05-12",
        "last_updated": "2015-06-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Y00000X",
            "taxonomy_group": "",
            "desc": "Otolaryngology",
            "state": "UT",
            "license": "5366856-1205",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Brisma Paulina Anderson
• Deryk L Anderson, MD
• Kristen Ann Anderson, CSW
• Megan Danielle Anderson, CSW
• Melissa Dawn Anderson
• Roberta Francis Anderson, F.N.P.
• Lindsie Anderton, LCSW
• Ashley Andreasen
• Rachel Maragret Andrews
• Espra L Andrus, LCSW

• Otolaryngology Physician in West Jordan, UT
• Providers in West Jordan, UT by specialty
• Otolaryngology Physician in Utah

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 23, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.