Morris Demoin Anderson, LPN

Primary specialty

Licensed Practical NurseTaxonomy code 164W00000X

License

043.126744 Issued in IL

Practice address

915 N Grand Blvd
Saint Louis, MO 63106-1621

Phone

(314) 652-4100

NPI assigned

Sep 25, 2019

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1569369600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1569369600000",
    "number": "1184275612",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4422 THUNDERBOLT DR",
            "city": "SCOTT AFB",
            "state": "IL",
            "postal_code": "622256301",
            "telephone_number": "253-468-2087"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "915 N GRAND BLVD",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631061621",
            "telephone_number": "314-652-4100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ANDERSON",
        "first_name": "MORRIS",
        "middle_name": "DEMOIN",
        "credential": "LPN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-09-25",
        "last_updated": "2019-09-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "SC",
            "license": "48498",
            "primary": false
        },
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "IL",
            "license": "043.126744",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Laura Ann Anderson, WHNP
• Madyson Talley Anderson, MD
• Matthew Neil Anderson, MED
• Megan Anderson
• Melissa Anderson, LPC
• Nicole Sabine Anderson
• Patrick Anderson
• Rachel Anderson
• Rapheale Anderson
• Regina Marie Anderson

• Licensed Practical Nurse in Saint Louis, MO
• Providers in Saint Louis, MO by specialty
• Licensed Practical Nurse in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 25, 2019; 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.