Individual provider Active NPI

Robert J Anderson, D.C.

  • Chiropractor
  • Honolulu, HI
National Provider Identifier
1063623957
Registry record updated Jan 27, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
858 Issued in HI
Practice address
3049 Ualena St
Suite 104
Honolulu, HI 96819-1942
Phone
(808) 834-8662
Fax
(808) 836-7627
NPI assigned
May 24, 2007
Last updated
Jan 27, 2009By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 27, 2009

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X DC007543-L PA
Chiropractor 111N00000X 858 HI Primary

Addresses

Primary practice location

3049 Ualena St
Suite 104
Honolulu, HI 96819-1942

Mailing address

3049 Ualena St
Suite 104
Honolulu, HI 96819-1942
Phone (808) 834-8662

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)
Enrolled

State licenses

LicenseStateTypeSpecialty
DC007543-LPAMDChiropractor
858HIMDPhysical Therapist

Networks

  • devoted network organization-c89d4c14-e90f-4cf7-83f9-456527a52335
  • HI PPO

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1179964800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1233014400000",
    "number": "1063623957",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3049 UALENA ST",
            "address_2": "SUITE 104",
            "city": "HONOLULU",
            "state": "HI",
            "postal_code": "968191942",
            "telephone_number": "808-834-8662",
            "fax_number": "808-836-7627"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3049 UALENA ST",
            "address_2": "SUITE 104",
            "city": "HONOLULU",
            "state": "HI",
            "postal_code": "968191942",
            "telephone_number": "808-834-8662",
            "fax_number": "808-836-7627"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ANDERSON",
        "first_name": "ROBERT",
        "middle_name": "J",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-05-24",
        "last_updated": "2009-01-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "PA",
            "license": "DC007543-L",
            "primary": false
        },
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "HI",
            "license": "858",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Honolulu, HI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 27, 2009; 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.