NPIMap

Individual provider Active NPI

Robert C Anderson, MD

  • Emergency Medicine Physician
  • Kremmling, CO
National Provider Identifier
1184708133
Registry record updated Feb 3, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
49568-020 Issued in WI
Practice address
214 South 4TH Street
Kremmling, CO 80459-0399
Phone
(970) 887-5800
NPI assigned
Oct 25, 2006
Last updated
Feb 3, 2020By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 3, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X 49568-020 WI Primary

Addresses

Primary practice location

214 South 4TH Street
Kremmling, CO 80459-0399

Mailing address

PO Box 8003
Appleton, WI 54912-8003
Phone (920) 996-3298

Other practice location 1

1405 Mill St
New London, WI 54961-2155
Phone (920) 531-2021

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address randerson289262@directe.centura.org Health Information Exchange (HIE)

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CO
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20091103000157 CO Practitioner - Family PracticePractitioner - Hospitalist 3971500976 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family PracticeAlso: Hospitalist
Education
Northeastern Ohio University College of Medicine, 1998
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

214 S 4TH St
Kremmling, CO 80459-0399
Phone (970) 724-3442

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
73.61 of 100Reported as group
Quality
76.83
Promoting interoperability
100
Improvement activities
40
Cost
35.19

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
49568-020WIMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Kremmling Memorial Hospital District CurrentSince Feb 2, 2014 Accepting new patients
Kremmling Memorial Hospital District CurrentSince Feb 2, 2014 Accepting new patients

Organizations & group practices 2

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.

Hospital & facility affiliations 7

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1161734400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1580688000000",
    "number": "1184708133",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 8003",
            "city": "APPLETON",
            "state": "WI",
            "postal_code": "549128003",
            "telephone_number": "920-996-3298"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "214 SOUTH 4TH STREET",
            "city": "KREMMLING",
            "state": "CO",
            "postal_code": "804590399",
            "telephone_number": "970-887-5800"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1405 Mill St",
            "address_purpose": "LOCATION",
            "city": "New London",
            "state": "WI",
            "postal_code": "549612155",
            "country_code": "US",
            "telephone_number": "920-531-2021",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ANDERSON",
        "first_name": "ROBERT",
        "middle_name": "C",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-25",
        "last_updated": "2020-02-03",
        "certification_date": "2020-02-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "WI",
            "license": "49568-020",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "randerson289262@directe.centura.org",
            "affiliation": "N",
            "endpointDescription": "RAnderson Middle Park Health DIRECT Email",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "CCD",
            "address_1": "214 South 4th Street",
            "city": "Kremmling",
            "state": "CO",
            "country_code": "US",
            "postal_code": "804590399",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Kremmling, CO

Sources for this page

Verify at the official NPI Registry.