Active NPI
Kent Ernest Anderson, M.D.
- Orthopaedic Surgery Physician
- Escanaba, MI
National Provider Identifier
1083615041
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Orthopaedic Surgery Physician
- License
- 4301043128
- Practice address
- 128 S 25TH St
Escanaba, MI 49829-1364 - Phone
- (906) 786-4100
- Fax
- (906) 786-3997
- NPI assigned
- Aug 2, 2005
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Orthopaedic Surgery Physician | 207X00000X | 4301043128 | MI | Primary |
Addresses
Primary practice location
128 S 25TH St
Escanaba, MI 49829-1364
Mailing address
128 S 25TH St
Escanaba, MI 49829-1364
Phone (906) 786-4100
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1419958 | Medicaid | MI | |
| 2002100152 | Other | MI | BCBSM |
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
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1122940800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1241568000000",
"number": "1083615041",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "128 S 25TH ST",
"city": "ESCANABA",
"state": "MI",
"postal_code": "498291364",
"telephone_number": "906-786-4100",
"fax_number": "906-786-3997"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "128 S 25TH ST",
"city": "ESCANABA",
"state": "MI",
"postal_code": "498291364",
"telephone_number": "906-786-4100",
"fax_number": "906-786-3997"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ANDERSON",
"first_name": "KENT",
"middle_name": "ERNEST",
"name_prefix": "Mr.",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2005-08-02",
"last_updated": "2009-05-06",
"status": "A"
},
"taxonomies": [
{
"code": "207X00000X",
"taxonomy_group": "",
"desc": "Orthopaedic Surgery",
"state": "MI",
"license": "4301043128",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1419958",
"state": "MI"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BCBSM",
"identifier": "2002100152",
"state": "MI"
}
],
"endpoints": [],
"other_names": []
}Other providers in Escanaba, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 6, 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.