Amanda Lee Anderson, D.C.
Individual provider Active NPI Chiropractor · Meridian, ID
NPI 1083735633 · NPPES record last updated Jun 8, 2023
Key facts
- NPI
- 1083735633
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Chiropractor 111N00000X
- License
- CHIA-1280 (ID)
- Practice address
- 845 E Fairview Ave
Suite 115
Meridian, ID 83642-8048 - Phone
- (208) 893-5401
- Fax
- (208) 893-5403
- NPI assigned
- Apr 2, 2007
- Sex
- Female
- Sole proprietor
- Yes
Medicare Care Compare profile
- Specialty
- Chiropractic
- Education
- Palmer College Chiropractic - West Sunnyvale, 2007
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
Practice addresses (Care Compare)
845 E Fairview Ave
Meridian, ID 83642-8048
Phone (208) 893-5401
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in ID
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20080514000423 | ID | Practitioner - Chiropractic | 4688743800 | Practice locations: Meridian, ID |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 6046 | CO | MD | Chiropractor |
| CHIA-1280 | ID | MD | Chiropractor |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Chiropractor | 111N00000X | 6046 | CO | |
| Chiropractor | 111N00000X | CHIA-1280 | ID | Yes |
Addresses
Primary practice location
845 E Fairview Ave
Suite 115
Meridian, ID 83642-8048
Mailing address
845 E Fairview Ave
Suite 115
Meridian, ID 83642-8048
Phone (208) 893-5401
Other providers in Meridian, ID
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jun 8, 2023. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.