NPIMap

Organization Active NPI

John K Anderson MD PC

  • Orthopaedic Surgery Physician
  • Ypsilanti, MI
National Provider Identifier
1194862326
Registry record updated Jan 13, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopaedic Surgery PhysicianTaxonomy code 207X00000X
License
061034 Issued in MI
Legal business name
JOHN K ANDERSON MD PC
Practice address
4972 W Clark Rd
Ste 200
Ypsilanti, MI 48197-0862
Phone
(734) 434-3020
Fax
(734) 434-3025
NPI assigned
Jan 30, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 13, 2012

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

Authorized official

Name
Stephanie Dean Basar
Title
Practice Manager
Phone
(734) 434-3020

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Orthopaedic Surgery PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207X00000X 061034 MI Primary

Addresses

Primary practice location

4972 W Clark Rd
Ste 200
Ypsilanti, MI 48197-0862

Mailing address

4972 W Clark Rd
Ste 200
Ypsilanti, MI 48197-0862
Phone (734) 434-3020

Other names 1

  • MICHIGAN SPORTSMEDICINE AND ORTHOPEDIC CENTER Doing business as

National Provider Directory

National Provider Directory

Locations

4972 W Clark Rd
Ste 200
Ypsilanti, MI 48197
Phone (734) 434-3020

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1170115200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1326412800000",
    "number": "1194862326",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4972 W CLARK RD",
            "address_2": "STE 200",
            "city": "YPSILANTI",
            "state": "MI",
            "postal_code": "481970862",
            "telephone_number": "734-434-3020",
            "fax_number": "734-434-3025"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4972 W CLARK RD",
            "address_2": "STE 200",
            "city": "YPSILANTI",
            "state": "MI",
            "postal_code": "481970862",
            "telephone_number": "734-434-3020",
            "fax_number": "734-434-3025"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JOHN K ANDERSON MD PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-30",
        "last_updated": "2012-01-13",
        "status": "A",
        "authorized_official_last_name": "BASAR",
        "authorized_official_first_name": "STEPHANIE",
        "authorized_official_middle_name": "DEAN",
        "authorized_official_title_or_position": "PRACTICE MANAGER",
        "authorized_official_telephone_number": "734-434-3020"
    },
    "taxonomies": [
        {
            "code": "207X00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Orthopaedic Surgery",
            "state": "MI",
            "license": "061034",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "MICHIGAN SPORTSMEDICINE AND ORTHOPEDIC CENTER",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Ypsilanti, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 13, 2012; 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.