David Ray Anderson, MD

Primary specialty

Ophthalmology PhysicianTaxonomy code 207W00000X

License

M3793 Issued in ID

Practice address

530 S Holmes
Idaho Falls, ID 83403-2410

Phone

(208) 529-3937

Fax

(208) 524-4380

NPI assigned

Feb 2, 2007

Sex

Male

Sole proprietor

No

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Jul 8, 2007.

{
    "created_epoch": "1170374400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1205974136",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2410",
            "city": "IDAHO FALLS",
            "state": "ID",
            "postal_code": "834032410",
            "telephone_number": "208-529-3937",
            "fax_number": "208-524-4380"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "530 S HOLMES",
            "city": "IDAHO FALLS",
            "state": "ID",
            "postal_code": "834032410",
            "telephone_number": "208-529-3937",
            "fax_number": "208-524-4380"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ANDERSON",
        "first_name": "DAVID",
        "middle_name": "RAY",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-02-02",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "ID",
            "license": "M3793",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• David Lynn Andersen, R.P.T., L.A.T, A.T.C
• Joe A Andersen, LPC
• Mikayla Andersen
• Carol V Anderson, PHD
• Cola Anderson
• Heather Annette Anderson, PHARM D
• Jaxon Dean Anderson, CRNA
• Jennifer Anderson
• Joseph D Anderson, PA-C
• Joseph M Anderson, DO

• All providers in Idaho Falls, ID
• Ophthalmology Physician in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.