Active NPI
Emily R Anderson Elder, MD
- Family Medicine Physician
- Greenley, CO
National Provider Identifier
1073772406
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- License
- 48233
- Practice address
- 1709 61St Ave.
Greenley, CO 80634 - Phone
- (970) 330-0333
- Fax
- (970) 686-3960
- NPI assigned
- Jun 2, 2008
- Last updated
- Aug 2, 2018
- 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | TL-2825 | CO | |
| Family Medicine Physician | 207Q00000X | 48233 | CO | Primary |
Addresses
Primary practice location
1709 61St Ave.
Greenley, CO 80634
Mailing address
1709 61St Ave
Greenley, CO 80634
Phone (970) 330-0333
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 73257567 | Medicaid | CO |
Other names 1
- Emily R Anderson
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
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 48233 | CO | MD | Family Medicine Physician |
| TL-2825 | CO | MD | Family Medicine Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1212364800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1533168000000",
"number": "1073772406",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1709 61ST AVE",
"city": "GREENLEY",
"state": "CO",
"postal_code": "80634",
"telephone_number": "970-330-0333",
"fax_number": "970-686-3960"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1709 61ST AVE.",
"city": "GREENLEY",
"state": "CO",
"postal_code": "80634",
"telephone_number": "970-330-0333",
"fax_number": "970-686-3960"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ANDERSON ELDER",
"first_name": "EMILY",
"middle_name": "R",
"name_prefix": "Dr.",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2008-06-02",
"last_updated": "2018-08-02",
"status": "A"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "CO",
"license": "TL-2825",
"primary": false
},
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "CO",
"license": "48233",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "73257567",
"state": "CO"
}
],
"endpoints": [],
"other_names": [
{
"first_name": "EMILY",
"last_name": "ANDERSON",
"middle_name": "R",
"credential": "MD",
"code": "1",
"type": "Former Name"
}
]
}
Other providers in Greenley, CO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 2, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.