Mike Anderson

Primary specialty

Child Intellectual and/or Developmental Disabilities Respite CareTaxonomy code 385HR2060X

Practice address

618 NW 1St St
Meridian, ID 83642-2505

Phone

(208) 407-2077

NPI assigned

Sep 16, 2010

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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

{
    "created_epoch": "1284595200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1284595200000",
    "number": "1194033746",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "618 NW 1ST ST",
            "city": "MERIDIAN",
            "state": "ID",
            "postal_code": "836422505"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "618 NW 1ST ST",
            "city": "MERIDIAN",
            "state": "ID",
            "postal_code": "836422505",
            "telephone_number": "208-407-2077"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ANDERSON",
        "first_name": "MIKE",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2010-09-16",
        "last_updated": "2010-09-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "385HR2060X",
            "taxonomy_group": "",
            "desc": "Respite Care, Respite Care, Intellectual and/or Developmental Disabilities, Child",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Emily Dawn Anderson, AGNP
• Heather Anderson, CST
• Jeanne Anderson
• Jessica Anderson, LMT
• Lisa Anderson, PHARMD
• Rebecca Lynn Anderson, LMT
• Steven Anderson, DPM
• Trevin Anderson
• Jodi Ann Anderst Keuhey, LCSW
• Bailey Allison Andreasen, WHNP-BC

• All providers in Meridian, ID
• Child Intellectual and/or Developmental Disabilities Respite Care in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 16, 2010; 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.