Rebecca Jane Anderson, D.O.

Primary specialty

General Practice PhysicianTaxonomy code 208D00000X

License

02000810 Issued in IN

Practice address

5610 Crawfordsville Rd Ste 103
Indianapolis, IN 46224-3714

Phone

(317) 247-0119

Fax

(317) 247-0614

NPI assigned

May 15, 2007

Sex

Female

Sole proprietor

No

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

Not listed in the public Medicare enrollment file

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.

Opted out of Medicare

Yes, effective Feb 26, 2019 through Feb 26, 2027

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

State licenses

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

{
    "created_epoch": "1179187200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1548201600000",
    "number": "1063628121",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5610 CRAWFORDSVILLE RD STE 103",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462243714",
            "telephone_number": "317-247-0119",
            "fax_number": "317-247-0614"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5610 CRAWFORDSVILLE RD STE 103",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462243714",
            "telephone_number": "317-247-0119",
            "fax_number": "317-247-0614"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ANDERSON",
        "first_name": "REBECCA",
        "middle_name": "JANE",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-05-15",
        "last_updated": "2019-01-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "IN",
            "license": "02000810",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Nicole S Anderson, LMHC
• Pamela Sue Anderson, ANP-BC
• Patricia Ann Anderson, LCSW
• Patricia Sue Anderson, ANP
• Rebecca Diane Anderson, MSW, LCSW
• Rebecca M Anderson, OTR
• Rebecca Taylor Anderson, MD
• Rodney J Anderson, D.O.
• Rosa M Anderson, MD
• Ryan David Anderson, MD

• General Practice Physician in Indianapolis, IN
• Providers in Indianapolis, IN by specialty
• General Practice Physician in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 23, 2019; 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; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.