Individual provider Active NPI

Luke Anderson, M.D.

  • Family Medicine Physician
  • Granbury, TX
National Provider Identifier
1083972939
Registry record updated Mar 24, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
Q3477 Issued in TX
Practice address
601 Fall Creek Hwy
Granbury, TX 76049-7960
Phone
(817) 326-3902
NPI assigned
Apr 29, 2012
Last updated
Mar 24, 2018By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 24, 2018

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X Q3477 TX
Family Medicine Physician 207Q00000X Q3477 TX Primary

Addresses

Primary practice location

601 Fall Creek Hwy
Granbury, TX 76049-7960

Mailing address

601 Fall Creek Hwy
Granbury, TX 76049-7960

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
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.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20150521000189 TX Practitioner - Family PracticePractitioner - Emergency Medicine 8527388255 Reassigns benefits to 4 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
Q3477TXMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Concord Medical Group PLLC Emergency Medicine CurrentSince Jun 26, 2015 Accepting new patients
Palo Pinto County Hospital District Current Accepting new patients
Palo Pinto County Hospital District Family Medicine CurrentSince Oct 4, 2015 Accepting new patients
Concord Medical Group of Texas PLLC Emergency Medicine CurrentSince Jun 26, 2015 Accepting new patients
Southwest Medical Associates, Inc. Emergency Medicine CurrentSince May 11, 2015 Accepting new patients
Palo Pinto County Hospital District Current Accepting new patients
Palo Pinto County Hospital District Family Medicine CurrentSince Oct 4, 2015 Accepting new patients

Locations

200 S Geneva St
Breckenridge, TX 76424
Phone (254) 559-2241

1416 George Dieter Dr
El Paso, TX 79936
Phone (877) 822-6281

310 W South St
Henrietta, TX 76365
Phone (806) 647-2191

400 SW 25th Ave
Mineral Wells, TX 76067
Phone (940) 325-7891

305 N McKinney St
Sweeny, TX 77480
Phone (979) 548-1500

Organizations & group practices 7

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1335657600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1521849600000",
    "number": "1083972939",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "601 FALL CREEK HWY",
            "city": "GRANBURY",
            "state": "TX",
            "postal_code": "760497960"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "601 FALL CREEK HWY",
            "city": "GRANBURY",
            "state": "TX",
            "postal_code": "760497960",
            "telephone_number": "817-326-3902"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ANDERSON",
        "first_name": "LUKE",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-04-29",
        "last_updated": "2018-03-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "TX",
            "license": "Q3477",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "TX",
            "license": "Q3477",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Granbury, TX

Sources for this page

Verify at the official NPI Registry.