Individual provider Active NPI

Jessica Anderson, MA, CPT

  • Phlebotomy Technician
  • Cordova, TN
National Provider Identifier
1245052232
Registry record updated Oct 30, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Phlebotomy TechnicianTaxonomy code 246RP1900X
Practice address
290 S Walnut Bend Rd Ste 1
Cordova, TN 38018-7280
Phone
(760) 818-3876
Fax
(901) 424-9021
NPI assigned
Oct 30, 2024
Last updated
Oct 30, 2024By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 30, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Phlebotomy Technician 246RP1900X TN Primary

Addresses

Primary practice location

290 S Walnut Bend Rd Ste 1
Cordova, TN 38018-7280

Mailing address

3807 Rainford Dr
Memphis, TN 38128-1989
Phone (760) 818-3876

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
Credentials
Master of Arts

NPI Registry JSON

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

{
    "created_epoch": "1730246400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1730246400000",
    "number": "1245052232",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3807 RAINFORD DR",
            "city": "MEMPHIS",
            "state": "TN",
            "postal_code": "381281989",
            "telephone_number": "760-818-3876",
            "fax_number": "901-424-9021"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "290 S WALNUT BEND RD STE 1",
            "city": "CORDOVA",
            "state": "TN",
            "postal_code": "380187280",
            "telephone_number": "760-818-3876",
            "fax_number": "901-424-9021"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ANDERSON",
        "first_name": "JESSICA",
        "credential": "MA, CPT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-10-30",
        "last_updated": "2024-10-30",
        "certification_date": "2024-10-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "246RP1900X",
            "taxonomy_group": "",
            "desc": "Technician, Pathology, Phlebotomy",
            "state": "TN",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cordova, TN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 30, 2024; 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.