Matthew Neil Anderson, MED

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

Practice address

3460 Hampton Ave Ste 204
Saint Louis, MO 63139-1938

Phone

(314) 669-6242

NPI assigned

Dec 23, 2021

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Matt Anderson Professional name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Education

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

{
    "created_epoch": "1640217600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1641513600000",
    "number": "1043970551",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5859 S KINGSHIGHWAY BLVD",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631093571",
            "telephone_number": "314-669-6242"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3460 HAMPTON AVE STE 204",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631391938",
            "telephone_number": "314-669-6242"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ANDERSON",
        "first_name": "MATTHEW",
        "middle_name": "NEIL",
        "credential": "MED",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-12-23",
        "last_updated": "2022-01-07",
        "certification_date": "2022-01-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "MO",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CAQH",
            "identifier": "15470693",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MATT",
            "last_name": "ANDERSON",
            "credential": "MED, PLPC",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

• Kourtney Anderson, MS
• Kristina Marie Anderson, M.D.
• Lamesa L Anderson
• Laura Ann Anderson, WHNP
• Madyson Talley Anderson, MD
• Megan Anderson
• Melissa Anderson, LPC
• Morris Demoin Anderson, LPN
• Nicole Sabine Anderson
• Patrick Anderson

• Professional Counselor in Saint Louis, MO
• Providers in Saint Louis, MO by specialty
• Professional Counselor in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 7, 2022; 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.