Michael Timothy Anderson

Primary specialty

Rehabilitation PractitionerTaxonomy code 225400000X

License

0801819438 Issued in NV

Practice address

255 W Moana LN Ste 104
Reno, NV 89509-4942

Phone

(775) 525-0270

NPI assigned

Oct 7, 2010

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• Renovation Mental Health Services, LLC

  • Community/Behavioral Health Agency
  • Reno, NV
  • NPI 1649615683
  NPD (past)

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

{
    "created_epoch": "1286409600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1448236800000",
    "number": "1114237245",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2840 ALBAZANO DR",
            "city": "SPARKS",
            "state": "NV",
            "postal_code": "894367050",
            "telephone_number": "775-232-6321"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "255 W MOANA LN STE 104",
            "city": "RENO",
            "state": "NV",
            "postal_code": "895094942",
            "telephone_number": "775-525-0270"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ANDERSON",
        "first_name": "MICHAEL",
        "middle_name": "TIMOTHY",
        "name_prefix": "Mr.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2010-10-07",
        "last_updated": "2015-11-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225400000X",
            "taxonomy_group": "",
            "desc": "Rehabilitation Practitioner",
            "state": "NV",
            "license": "0801819438",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Lanette Anderson
• Letecia Anderson, PT
• Lynee Anderson, NBC-HIS
• Lynice Anderson, RD, CDE
• Lynn Anderson, APN
• Milan John Anderson, D.C,BSC
• Mitchell Anderson
• Nicholas John Anderson
• Nicole Marie Anderson, MS, CCC-SLP, CAS
• Novia Jean Anderson

• All providers in Reno, NV
• Rehabilitation Practitioner in Nevada

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 23, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.