Brandon Mark Anderson, RN, CNP
Individual provider Active NPI Nurse Practitioner · Orr, MN
NPI 1225536592 · NPPES record last updated Jul 31, 2020
Key facts
- NPI
- 1225536592
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Nurse Practitioner 363L00000X
- License
- XXX (MN)
- Practice address
- 5219 Saint John Dr
Orr, MN 55771-8232 - Phone
- (218) 757-3650
- NPI assigned
- Jan 31, 2018
- Sex
- Male
- Sole proprietor
- Yes
Organizations & group practices 3
Medicare Care Compare profile
- Specialty
- Nurse Practitioner
- Education
- University of North Dakota School of Medicine, 2020
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Bois Forte Reservation Tribal Government
Practice addresses (Care Compare)
5219 Saint John Dr
Orr, MN 55771-8232
Phone (218) 757-3650
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in MN
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20200921001386 | MN | Practitioner - Nurse Practitioner | 2466870639 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Certified Nurse Practitioner, Nurse Practitioner, Registered Nurse
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 227183-7 | MN | MD | Registered Nurse |
| 7589 | MN | MD | Physical Therapist |
| XXX | MN | MD | Chore Provider |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Bois Forte Reservation Tribal Government | Current | Accepting new patients | |
| Bois Forte Reservation Tribal Government | Current |
Accepting new patients |
Locations
13071 Nett Lake Rd
Orr, MN 55771
Phone (218) 757-3650
5219 Saint John Dr
Orr, MN 55771
Phone (218) 757-3431
1613 Farm Rd S
#100
Tower, MN 55790
1613 Farm Rd S
Tower, MN 55790
Phone (218) 753-2180
1610 Farm Rd S
Tower, MN 55790
Phone (218) 753-2182
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Registered Nurse | 163W00000X | 227183-7 | MN | |
| Nurse Practitioner | 363L00000X | XXX | MN | Yes |
Addresses
Primary practice location
5219 Saint John Dr
Orr, MN 55771-8232
Mailing address
5219 Saint John Dr
Orr, MN 55771-8232
Phone (218) 757-3650
Other providers in Orr, MN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 31, 2020. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.