NPIMap

Individual provider Active NPI

Christopher E Anderson, MD

  • Emergency Medicine Physician
  • Fargo, ND
National Provider Identifier
1184871758
Registry record updated Apr 14, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
12984 Issued in ND
Practice address
3000 32ND Ave S
Fargo, ND 58103-6132
Phone
(701) 364-8000
Fax
(701) 364-8078
NPI assigned
Aug 26, 2008
Last updated
Apr 14, 2014By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 14, 2014

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X 12984 ND Primary
Emergency Medicine Physician 207P00000X 51847 MN

Addresses

Primary practice location

3000 32ND Ave S
Fargo, ND 58103-6132

Mailing address

PO Box 6001
Fargo, ND 58108-6001
Phone (701) 364-8000

Other identifiers 1

IdentifierTypeStateIssuer
17605MedicaidND

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MN, ND2 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20091014000763 MN Practitioner - Emergency Medicine 7416093828 Reassigns benefits to 5 organizations
I20131030000833 ND Practitioner - Emergency Medicine 7416093828 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Emergency Medicine
Education
University of North Dakota School of Medicine, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
First Care Medical ServicesGroup PAC ID 3678542842, shared by 6 NPIs, 22 clinicians
Bridges Medical CenterGroup PAC ID 4981659851, shared by 3 NPIs, 22 clinicians
Innovis Health LLCGroup PAC ID 9931298155, 561 clinicians

Practice addresses (Care Compare)

121 Central St W
Bagley, MN 56621-4393
Phone (218) 694-6281

201 9TH St W
Ada, MN 56510-1279

3000 32ND Ave S
Fargo, ND 58103-6132
Phone (701) 364-8000

400 Governor St
Oklee, MN 56742-4227
Phone (218) 796-4525

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
51847MNMDEmergency Medicine Physician
12984NDMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
First Care Medical Services CurrentSince Apr 21, 2022 Accepting new patients
Innovis Health LLC CurrentSince Sep 30, 2013 Accepting new patients
Innovis Health LLC CurrentSince Sep 30, 2013 Accepting new patients
Innovis Health, LLC Current Accepting new patients
St. Mary's Regional Health Center CurrentSince Apr 21, 2022 Accepting new patients
First Care Medical Services CurrentSince Apr 21, 2022 Accepting new patients
St. Marys Regional Health Center Current Accepting new patients
St Mary's Regional Health Center CurrentSince Apr 21, 2022 Accepting new patients
Mayo Clinic Past Accepting new patients
St Marys Regional Health Center Past Accepting new patients

Locations

201 9th St W
Ada, MN 56510
Phone (218) 784-2727

1027 Washington Ave
Detroit Lakes, MN 56501
Phone (218) 844-2300

900 Hilligoss Blvd SE
Fosston, MN 56542
Phone (218) 435-1133

1702 University Dr S
Fargo, ND 58103
Phone (701) 364-4222

3000 32nd Ave S
Fargo, ND 58103
Phone (701) 364-3000

Organizations & group practices 12

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 5

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": "1219708800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1397433600000",
    "number": "1184871758",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 6001",
            "city": "FARGO",
            "state": "ND",
            "postal_code": "581086001",
            "telephone_number": "701-364-8000",
            "fax_number": "701-364-8078"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3000 32ND AVE S",
            "city": "FARGO",
            "state": "ND",
            "postal_code": "581036132",
            "telephone_number": "701-364-8000",
            "fax_number": "701-364-8078"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ANDERSON",
        "first_name": "CHRISTOPHER",
        "middle_name": "E",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-08-26",
        "last_updated": "2014-04-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "ND",
            "license": "12984",
            "primary": true
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "MN",
            "license": "51847",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "17605",
            "state": "ND"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Fargo, ND

Sources for this page

Verify at the official NPI Registry.