Individual provider Active NPI

Carter Scott Anderson, P.A.

  • Physician Assistant
  • Springerville, AZ
National Provider Identifier
1124102702
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
3291 Issued in AZ
Practice address
118 S Mountain Ave
Springerville, AZ 85938-5104
Phone
(928) 333-4368
Fax
(928) 333-4369
NPI assigned
Oct 24, 2006
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 3291 AZ Primary

Addresses

Primary practice location

118 S Mountain Ave
Springerville, AZ 85938-5104

Mailing address

118 S Mountain Ave
Springerville, AZ 85938-5104
Phone (928) 333-4368

Other identifiers 1

IdentifierTypeStateIssuer
442525MedicaidAZ

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240430003262 TX Practitioner - Physician Assistant 3072588227 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 1996
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

500 Indiana Ave
Winslow, AZ 86047-2169

500 N Indiana Ave
Winslow, AZ 86047-2169
Phone (928) 289-4646

SWC Navajo Route 15 and 60
1 Medical Center Dr
Dilkon, AZ 86047-2169
Phone (928) 289-4646

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
3291AZMDOccupational Therapy Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Dilkon Medical Center Current Accepting new patients
Winslow Indian Health Care Center, Inc CurrentSince Mar 5, 2024 Accepting new patients
Emergency Physicians Professional Association LTD Past Accepting new patients
White Mountain Anesthesia LTD Past Accepting new patients
Mountain View Family Practice PastSince Mar 1, 2005 Accepting new patients
Scott R Hamblin MD, PC Past Accepting new patients

Locations

1501 N Williamson Ave
Winslow, AZ 86047
Phone (928) 289-4691

500 Indiana Ave
Winslow, AZ 86047

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": "1161648000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1124102702",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "118 S MOUNTAIN AVE",
            "city": "SPRINGERVILLE",
            "state": "AZ",
            "postal_code": "859385104",
            "telephone_number": "928-333-4368",
            "fax_number": "928-333-4369"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "118 S MOUNTAIN AVE",
            "city": "SPRINGERVILLE",
            "state": "AZ",
            "postal_code": "859385104",
            "telephone_number": "928-333-4368",
            "fax_number": "928-333-4369"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ANDERSON",
        "first_name": "CARTER",
        "middle_name": "SCOTT",
        "name_prefix": "Mr.",
        "credential": "P.A.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-24",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "AZ",
            "license": "3291",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "442525",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Springerville, AZ

Sources for this page

Verify at the official NPI Registry.