Active NPI
Ljudevit Andres, M.D.
- Gastroenterology Physician
- Prescott, AZ
National Provider Identifier
1174508998
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Gastroenterology Physician
- License
- 32009
- Practice address
- 811 Ainsworth Dr
Suite 103
Prescott, AZ 86301-1687 - Phone
- (928) 771-5548
- Fax
- (928) 771-5549
- NPI assigned
- Dec 14, 2005
- Last updated
- Jun 4, 2014
- Sex
- Male
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Gastroenterology Physician | 207RG0100X | 32009 | AZ | Primary |
Addresses
Primary practice location
811 Ainsworth Dr
Suite 103
Prescott, AZ 86301-1687
Mailing address
PO Box 10880
Prescott, AZ 86304-0880
Phone (928) 771-0304
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 834722 | Medicaid | AZ |
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)
- Enrolled
- Credentials
- Doctor of Medicine
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1134518400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1401840000000",
"number": "1174508998",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 10880",
"city": "PRESCOTT",
"state": "AZ",
"postal_code": "863040880",
"telephone_number": "928-771-0304",
"fax_number": "928-458-2039"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "811 AINSWORTH DR",
"address_2": "SUITE 103",
"city": "PRESCOTT",
"state": "AZ",
"postal_code": "863011687",
"telephone_number": "928-771-5548",
"fax_number": "928-771-5549"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ANDRES",
"first_name": "LJUDEVIT",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2005-12-14",
"last_updated": "2014-06-04",
"status": "A"
},
"taxonomies": [
{
"code": "207RG0100X",
"taxonomy_group": "",
"desc": "Internal Medicine, Gastroenterology",
"state": "AZ",
"license": "32009",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "834722",
"state": "AZ"
}
],
"endpoints": [],
"other_names": []
}Other providers in Prescott, AZ
- Larry Dean Anderson, R.PH.
- Marion Elizabeth Anderson, LMFT
- Mary Elizabeth Anderson, MA, LMFT
- Russell A. Anderson, MSW
- Sabrina E Anderson, DC
- Cameron D Andrew, DDS
- Victoria Michelle Angel, APRN, FNP-BC
- Angela Seesholtz Counseling Dba Resilient Brain Prescott (Angela Seesholtz Counseling PLLC)
- Anson L Hooper DDS PLLC (Hooper Family Dental)
- Thresiamma S Anthony, RN, MSN-FNP-C
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 4, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.