Individual provider Active NPI

Denise Lynn Anderson

  • Surgical Physician Assistant
  • Branson, MO
National Provider Identifier
1104500388
Registry record updated Jan 29, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgical Physician AssistantTaxonomy code 363AS0400X
License
2024044299 Issued in MO
Practice address
121 Cahill Rd
Branson, MO 65616-2036
Phone
(417) 348-8100
NPI assigned
Jun 9, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 29, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgical Physician Assistant 363AS0400X 2024044299 MO Primary

Addresses

Primary practice location

121 Cahill Rd
Branson, MO 65616-2036

Mailing address

121 Cahill Rd
Branson, MO 65616-2036

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MO
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250102001270 MO Practitioner - Physician Assistant 9830626845 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Skaggs Community Hospital Association 222 clinicians

Practice addresses (Care Compare)

121 Cahill Rd
Suite 206
Branson, MO 65616-1911
Phone (417) 348-8100

Hospital & facility affiliations

  • Cox Medical Center Branson Hospital, Branson, MO, CCN 260094

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
2024044299MOMDSurgical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Skaggs Community Hospital Association CurrentSince Jan 27, 2025 Accepting new patients
Skaggs Community Hospital Association CurrentSince Jan 27, 2025 Accepting new patients
Skaggs Community Hospital Association Past Accepting new patients

Locations

121 Cahill Rd
Ste 206
Branson, MO 65616
Phone (417) 348-8100

Organizations & group practices 18

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

View all 18

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1686268800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1738108800000",
    "number": "1104500388",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "121 CAHILL RD",
            "city": "BRANSON",
            "state": "MO",
            "postal_code": "656162036"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "121 CAHILL RD",
            "city": "BRANSON",
            "state": "MO",
            "postal_code": "656162036",
            "telephone_number": "417-348-8100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ANDERSON",
        "first_name": "DENISE",
        "middle_name": "LYNN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-06-09",
        "last_updated": "2025-01-29",
        "certification_date": "2025-01-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "MO",
            "license": "2024044299",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Branson, MO

Sources for this page

Verify at the official NPI Registry.