Active NPI
Eric Anderson
- Customized Equipment (DME)
- Baltimore, MD
National Provider Identifier
1235239872
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Customized Equipment (DME)
- License
- 87560
- Practice address
- 105 Sudbrook LN
Baltimore, MD 21208-4120 - Phone
- (410) 365-7086
- Fax
- (443) 940-1076
- NPI assigned
- Sep 24, 2006
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Customized Equipment (DME) | 332BC3200X | 87560 | MD | Primary |
Addresses
Primary practice location
105 Sudbrook LN
Baltimore, MD 21208-4120
Mailing address
105 Sudbrook LN
Baltimore, MD 21208-4120
Phone (410) 365-7086
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 87560 | MD | MD | Customized Equipment (DME) |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1159056000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1235239872",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "105 SUDBROOK LN",
"city": "BALTIMORE",
"state": "MD",
"postal_code": "212084120",
"telephone_number": "410-365-7086",
"fax_number": "443-940-1076"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "105 SUDBROOK LN",
"city": "BALTIMORE",
"state": "MD",
"postal_code": "212084120",
"telephone_number": "410-365-7086",
"fax_number": "443-940-1076"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ANDERSON",
"first_name": "ERIC",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-09-24",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "332BC3200X",
"taxonomy_group": "",
"desc": "Durable Medical Equipment & Medical Supplies, Customized Equipment",
"state": "MD",
"license": "87560",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Baltimore, MD
Sources for this page
- 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.