NPIMap

Organization Active NPI

Michael B Anderson, MD PC

  • Orthopaedic Surgery Physician
  • St George, UT
National Provider Identifier
1215964747
Registry record updated Dec 20, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopaedic Surgery PhysicianTaxonomy code 207X00000X
License
1722171205 Issued in UT
Legal business name
MICHAEL B ANDERSON, MD PC
Practice address
1490 E Foremaster Dr
# 150
St George, UT 84790-4488
Phone
(435) 628-9393
NPI assigned
Jun 28, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 20, 2007

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

Authorized official

Name
Dr. Michael B AndersonNPI 1093792210
Title
Owner
Phone
(435) 628-9393

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Orthopaedic Surgery PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207X00000X 1722171205 UT Primary

Addresses

Primary practice location

1490 E Foremaster Dr
# 150
St George, UT 84790-4488

Mailing address

1490 E Foremaster Dr
# 150
St George, UT 84790-4488
Phone (435) 628-9393

Other identifiers 1

IdentifierTypeStateIssuer
528849385003MedicaidUT

Other names 1

  • CORAL DESERT ORTHOPAEDICS Doing business as

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

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": "1151452800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1198108800000",
    "number": "1215964747",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1490 E FOREMASTER DR",
            "address_2": "# 150",
            "city": "ST GEORGE",
            "state": "UT",
            "postal_code": "847904488",
            "telephone_number": "435-628-9393"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1490 E FOREMASTER DR",
            "address_2": "# 150",
            "city": "ST GEORGE",
            "state": "UT",
            "postal_code": "847904488",
            "telephone_number": "435-628-9393"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MICHAEL B ANDERSON, MD PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-28",
        "last_updated": "2007-12-20",
        "status": "A",
        "authorized_official_last_name": "ANDERSON",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_middle_name": "B",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "435-628-9393",
        "authorized_official_name_prefix": "Dr."
    },
    "taxonomies": [
        {
            "code": "207X00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Orthopaedic Surgery",
            "state": "UT",
            "license": "1722171205",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "528849385003",
            "state": "UT"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "CORAL DESERT ORTHOPAEDICS",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in St George, UT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 20, 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.