Individual provider Active NPI

Darrell E Anderson, HIS

  • Hearing Instrument Specialist
  • Wytheville, VA
National Provider Identifier
1083041453
Registry record updated Feb 9, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Hearing Instrument SpecialistTaxonomy code 237700000X
License
2101001394 Issued in VA
Practice address
680 W Lee Hwy
Wytheville, VA 24382-1708
Phone
(276) 228-0866
Fax
(540) 674-1666
NPI assigned
Oct 1, 2013
Last updated
Feb 9, 2025By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 9, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Hearing Instrument Specialist 237700000X 2101001394 VA Primary

Addresses

Primary practice location

680 W Lee Hwy
Wytheville, VA 24382-1708

Mailing address

85 Cleburne Blvd
Dublin, VA 24084-4435
Phone (540) 674-4889

Other practice location 1

3607 S Main St
Blacksburg, VA 24060-7014
Phone (540) 381-6967

Other practice location 2

8052 Carrollton Pike
Galax, VA 24333-6087
Phone (276) 236-0778

Other practice location 3

85 Cleburne Blvd
Dublin, VA 24084-4435
Phone (540) 674-4889

Other identifiers 1

IdentifierTypeStateIssuer
2101001394OtherVASTATE LICENSE

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)
Not enrolled

State licenses

LicenseStateTypeSpecialty
2101001394VAMDHearing Instrument Specialist

NPI Registry JSON

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

{
    "created_epoch": "1380585600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1739059200000",
    "number": "1083041453",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "85 CLEBURNE BLVD",
            "city": "DUBLIN",
            "state": "VA",
            "postal_code": "240844435",
            "telephone_number": "540-674-4889",
            "fax_number": "540-674-1666"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "680 W LEE HWY",
            "city": "WYTHEVILLE",
            "state": "VA",
            "postal_code": "243821708",
            "telephone_number": "276-228-0866",
            "fax_number": "540-674-1666"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3607 S Main St",
            "address_purpose": "LOCATION",
            "city": "Blacksburg",
            "state": "VA",
            "postal_code": "240607014",
            "country_code": "US",
            "telephone_number": "540-381-6967",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "8052 Carrollton Pike",
            "address_purpose": "LOCATION",
            "city": "Galax",
            "state": "VA",
            "postal_code": "243336087",
            "country_code": "US",
            "telephone_number": "276-236-0778",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "85 Cleburne Blvd",
            "address_purpose": "LOCATION",
            "city": "Dublin",
            "state": "VA",
            "postal_code": "240844435",
            "country_code": "US",
            "telephone_number": "540-674-4889",
            "fax_number": "540-674-1666",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ANDERSON",
        "first_name": "DARRELL",
        "middle_name": "E",
        "name_prefix": "Mr.",
        "credential": "HIS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-10-01",
        "last_updated": "2025-02-09",
        "certification_date": "2025-02-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "237700000X",
            "taxonomy_group": "",
            "desc": "Hearing Instrument Specialist",
            "state": "VA",
            "license": "2101001394",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSE",
            "identifier": "2101001394",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Wytheville, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 9, 2025; 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.