Active NPI
David Michael Anderson III
- Attendant Care Provider
- Sanford, FL
National Provider Identifier
1154035053
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Attendant Care Provider
- License
- 30212329
- Practice address
- 204 N Elm Ave Ste 102
Sanford, FL 32771-1272 - Phone
- (407) 878-0048
- Fax
- (407) 878-7099
- NPI assigned
- Jan 6, 2023
- Last updated
- Jan 6, 2023
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Attendant Care Provider | 3747A0650X | 30212329 | FL | Primary |
Addresses
Primary practice location
204 N Elm Ave Ste 102
Sanford, FL 32771-1272
Mailing address
204 N Elm Ave Ste 102
Sanford, FL 32771-1272
Phone (407) 878-0048
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 105053600 | Medicaid | FL |
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Other URL | ABSOLUTEHEALTH@GMX.COM | Absolute Health Professionals Inc. |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 30212329 | FL | MD | Attendant Care Provider |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Absolute Health Professionals Inc | Current | Accepting new patients |
Locations
204 N Elm Ave
Ste 102
Sanford, FL 32771
Phone (407) 878-0048
Organizations & group practices 1
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.
-
- Home Health Agency
- Sanford, FL
- NPI 1093429334
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1672963200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1672963200000",
"number": "1154035053",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "204 N ELM AVE STE 102",
"city": "SANFORD",
"state": "FL",
"postal_code": "327711272",
"telephone_number": "407-878-0048",
"fax_number": "407-878-7099"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "204 N ELM AVE STE 102",
"city": "SANFORD",
"state": "FL",
"postal_code": "327711272",
"telephone_number": "407-878-0048",
"fax_number": "407-878-7099"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ANDERSON",
"first_name": "DAVID",
"middle_name": "MICHAEL",
"name_prefix": "Mr.",
"name_suffix": "III",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2023-01-06",
"last_updated": "2023-01-06",
"certification_date": "2023-01-06",
"status": "A"
},
"taxonomies": [
{
"code": "3747A0650X",
"taxonomy_group": "",
"desc": "Technician, Attendant Care Provider",
"state": "FL",
"license": "30212329",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "105053600",
"state": "FL"
}
],
"endpoints": [
{
"endpointType": "OTHERS",
"endpointTypeDescription": "Other URL",
"endpoint": "ABSOLUTEHEALTH@GMX.COM",
"affiliation": "Y",
"affiliationName": "Absolute Health Professionals Inc.",
"address_1": "204 N Elm Ave Ste 102",
"city": "Sanford",
"state": "FL",
"country_code": "US",
"postal_code": "327711272",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}
Other providers in Sanford, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 6, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.