NPIMap

Individual provider Active NPI

William Robert Anderson, DO

  • Family Medicine Physician
  • Gore, OK
National Provider Identifier
1235130709
Registry record updated Dec 27, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
2597 Issued in OK
Practice address
700 N Main
Gore, OK 74435
Phone
(918) 489-5757
Fax
(918) 489-5411
NPI assigned
Aug 9, 2005
Last updated
Dec 27, 2011By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 27, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 2597 OK Primary

Addresses

Primary practice location

700 N Main
Gore, OK 74435

Mailing address

PO Box 479
Gore, OK 74435
Phone (918) 489-5757

Other identifiers 3

IdentifierTypeStateIssuer
100257880CMedicaidOK
100257880EMedicaidOK
100257880AMedicaidOK

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OK
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040226000668 OK Practitioner - Family PracticePractitioner - General PracticePractitioner - Geriatric Medicine 0648166520 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family PracticeAlso: General Practice, Geriatric Medicine
Education
Oklahoma State University College of Osteopathic Medicine, 1986
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Neok Chronic CareGroup PAC ID 8729528914, 6 clinicians

Practice addresses (Care Compare)

1003 N Main St
Gore, OK 74435-2015
Phone (918) 880-2273

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
18.92 of 100Reported as individual
Quality
0
Improvement activities
0
Cost
63.06

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

State licenses

LicenseStateTypeSpecialty
2597OKMDSurgical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
LTC Solutions, PLLC Family Medicine CurrentSince Jun 30, 2014 Accepting new patients
Neok Chronic Care CurrentSince Sep 1, 2024 Accepting new patients
Hospice Advantage, LLC CurrentSince Mar 1, 2022 Accepting new patients
Hospice Advantage, LLC CurrentSince Mar 1, 2022 Accepting new patients
Houston Vein and Vascular PLLC Past Accepting new patients
McAlester Regional Health Center Authority Past Accepting new patients
Countryside Health Services, LLC Past Accepting new patients
Gore Health Services, LLC Past Accepting new patients
University Northwest, LLC Past Accepting new patients
Gore Green Country Drug, Inc. Past Accepting new patients
Cherokee County Nursing Center Inc Past Accepting new patients
Northeastern Health System Past Accepting new patients
Heritage Hills Nursing Center Inc Past Accepting new patients
Brentwood Extended Care & Rehab. LLC Past Accepting new patients
Eufaula Care Center Inc Past Accepting new patients
Checotah Nursing and Rehabilitation LLC Past Accepting new patients
Hartshorne Health Services, LLC Past Accepting new patients
Aspire Management LLC Past Accepting new patients
Pleasant Valley Health Care Center, Inc Past Accepting new patients
Muskogee Health Services LLC Past Accepting new patients

Locations

1003 N Main St
Gore, OK 74435
Phone (918) 880-2273

305 N Main St
Gore, OK 74435
Phone (918) 489-5558

604 N Main St
Gore, OK 74435
Phone (918) 489-5259

1120 Illinois St
Muskogee, OK 74403
Phone (918) 682-5391

1325 E 15th St
Ste 205
Tulsa, OK 74120
Phone (918) 300-4939

4612 S Harvard Ave
Ste E
Tulsa, OK 74135
Phone (918) 770-7687

35904 S Highway 82
Vinita, OK 74301
Phone (918) 782-1414

10 Cadillac Dr
Ste 400
Brentwood, TN 37027
Phone (615) 637-9163

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/AFJICD
  • Direct secure messaging: william.anderson.1@21087.direct.athenahealth.com

Ownership & related parties

All facility ownership & control disclosures 7

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Pleasant Valley Health Care Center,Muskogee, OK, CCN 375451 Skilled nursing facility Adp of the SNF Jan 16, 2025
Eufaula Manor Nursing and Rehabilitation CenterEufaula, OK, CCN 375395 Skilled nursing facility Operational/Managerial Control
Adp of the SNF		 Dec 10, 2024
Dec 10, 2024
Muskogee Nursing CenterMuskogee, OK, CCN 375376 Skilled nursing facility Operational/Managerial Control
Adp of the SNF		 Apr 1, 2025
Apr 1, 2025
Community Healthcare of GoreGore, OK, CCN 375295 Skilled nursing facility Adp of the SNF Dec 8, 2025
Heritage Hills Living and Rehabilitation CenterMcAlester, OK, CCN 375317 Skilled nursing facility Operational/Managerial Control
Adp of the SNF		 Apr 1, 2024
Apr 1, 2024
New Hope Retirement & Care CenterMcAlester, OK, CCN 375384 Skilled nursing facility Operational/Managerial Control
Adp of the SNF		 Jun 1, 2025
Jun 1, 2025
Sequoyah Family ClinicSallisaw, OK, CCN 378559 Rural health clinic Corporate Officer Jun 30, 2021

Owned or controlled facilities with NPI records 7

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Organizations & group practices 21

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

View all 21

Hospital & facility affiliations 18

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

View all 18

NPI Registry JSON

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

{
    "created_epoch": "1123545600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1324944000000",
    "number": "1235130709",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 479",
            "city": "GORE",
            "state": "OK",
            "postal_code": "74435",
            "telephone_number": "918-489-5757",
            "fax_number": "918-489-5411"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "700 N MAIN",
            "city": "GORE",
            "state": "OK",
            "postal_code": "74435",
            "telephone_number": "918-489-5757",
            "fax_number": "918-489-5411"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ANDERSON",
        "first_name": "WILLIAM",
        "middle_name": "ROBERT",
        "credential": "DO",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-08-09",
        "last_updated": "2011-12-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "OK",
            "license": "2597",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100257880C",
            "state": "OK"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100257880E",
            "state": "OK"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100257880A",
            "state": "OK"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Gore, OK

Sources for this page

Verify at the official NPI Registry.