Nancy A Anderson, PA-C

Primary specialty

Surgical Physician AssistantTaxonomy code 363AS0400X

License

002106 Issued in GA

Practice address

1505 Northside Blvd
Ste 2400
Cumming, GA 30041-7623

Phone

(770) 292-3490

Fax

(404) 851-6283

NPI assigned

Aug 31, 2006

Last updated

Feb 2, 2017By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 3

Medicare fee-for-service enrollment

Enrolled in GA, MT2 enrollments

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 2

Specialty

Physician Assistant

Education

Emory University School of Medicine, 1989

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Northside Surgical Professional Services LLCGroup PAC ID 8628253424, 367 clinicians

SCL Health Medical Group - Billings LLCGroup PAC ID 9638491574, 291 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Intermountain Health St Vincent Regional Hospital Hospital, Billings, MT, CCN 270049

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://api.platform.athenahealth.com/21378/brand/1/csg/1/fhir/r4

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.

• SCL Health Medical Group - Billings LLC

  dba St Vincent Healthcare

  • Clinic/Center
  • Billings, MT
  • NPI 1508289703
  Medicare reassignment Care Compare group NPD
• Northside Surgical Professional Services LLC

  • Surgery Physician
  • Atlanta, GA
  • NPI 1356630990
  Medicare reassignment Care Compare group
• SCL Health Medical Group - Billings, LLC

  dba Billings - DPP (Diabetes Prevention Program)

  • Endocrinology, Diabetes & Metabolism Physician
  • Billings, MT
  • NPI 1003701558
  NPD
• Peachtree Orthopaedic Clinic PA

  • Orthopaedic Surgery Physician
  • Atlanta, GA
  • NPI 1811912611
  NPD (past)
• Perimeter Orthopaedics, P.C.

  • Orthopaedic Foot and Ankle Surgery Physician
  • Atlanta, GA
  • NPI 1275601171
  NPD (past)

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

• SCL Health Montana

  dba Intermountain Health St Vincent Regional Hospital

  • General Acute Care Hospital
  • Billings, MT
  • NPI 1083655997
  Care Compare affiliation
• St. Vincent Healthcare

  • General Acute Care Hospital
  • Billings, MT
  • NPI 1396916276
  Care Compare affiliation

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

{
    "created_epoch": "1156982400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1485993600000",
    "number": "1104937317",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1505 NORTHSIDE BLVD",
            "address_2": "STE 2400",
            "city": "CUMMING",
            "state": "GA",
            "postal_code": "300417623",
            "telephone_number": "770-292-3490",
            "fax_number": "404-851-6283"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1505 NORTHSIDE BLVD",
            "address_2": "STE 2400",
            "city": "CUMMING",
            "state": "GA",
            "postal_code": "300417623",
            "telephone_number": "770-292-3490",
            "fax_number": "404-851-6283"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ANDERSON",
        "first_name": "NANCY",
        "middle_name": "A",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-31",
        "last_updated": "2017-02-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "GA",
            "license": "002106",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "003119970D",
            "state": "GA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "003119970C",
            "state": "GA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "003119970B",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Amy Alisa Anderson, RD
• Deanna Anderson, M.ED., CCC-SLP
• Jennifer L Anderson, RN
• Madelene Anderson
• Mark D Anderson, LPC
• Sally Anderson, LPC
• Scott E Anderson, PA-C
• Melinda Danielle Andre, LCSW
• Angels All Around Home Care Service Inc.
• Angels All Around Inc

• Surgical Physician Assistant in Cumming, GA
• Providers in Cumming, GA by specialty
• Surgical Physician Assistant in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 2, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.