Eddie Evan Anderson, D.O.

Primary specialty

Emergency Medicine PhysicianTaxonomy code 207P00000X

License

1995 Issued in WV

Practice address

100 Hoylman Dr
Gassaway, WV 26624-9321

Phone

(304) 364-5156

NPI assigned

Jun 6, 2006

Last updated

Apr 1, 2020By the provider in NPPES

Sex

Male

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 1

Medicare fee-for-service enrollment

Enrolled in WV

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

State licenses

Practice roles

Locations

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.

• Little Kanawha Family Medicine PLLC

  • Family Medicine Physician
  • Glenville, WV
  • NPI 1295770600
  Medicare reassignment NPD

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

{
    "created_epoch": "1149552000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1585699200000",
    "number": "1154360634",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "604 W MAIN ST",
            "city": "GLENVILLE",
            "state": "WV",
            "postal_code": "263511058"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 HOYLMAN DR",
            "city": "GASSAWAY",
            "state": "WV",
            "postal_code": "266249321",
            "telephone_number": "304-364-5156"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1 Healthcare Dr",
            "address_purpose": "LOCATION",
            "city": "Philippi",
            "state": "WV",
            "postal_code": "264169405",
            "country_code": "US",
            "telephone_number": "304-457-1760",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ANDERSON",
        "first_name": "EDDIE",
        "middle_name": "EVAN",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-06",
        "last_updated": "2020-04-01",
        "certification_date": "2020-04-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "WV",
            "license": "1995",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "PENDING",
            "state": "WV"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Antoine Katiny MD (Braxton Imaging)
• Mac Gene Bailes, DO
• Elizabeth Barnett
• Angela Grace Barnette, LPN
• Kassie Marie Belknap

• Emergency Medicine Physician in Gassaway, WV
• Providers in Gassaway, WV by specialty
• Emergency Medicine Physician in West Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 1, 2020; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.