Jacqueline Anne Anderson, M.D.

Primary specialty

Otolaryngology PhysicianTaxonomy code 207Y00000X

License

18224 Issued in ND

Practice address

Landstuhl Regional Medical Center
Unit 33100
Apo, AE 09180-3100

Phone

(314) 590-5428

NPI assigned

Apr 18, 2011

Last updated

Mar 12, 2024By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Jacqueline Anne Christensen Former name

Medicare fee-for-service enrollment

Enrolled in ND

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Otolaryngology

Education

Uniformed Services Uhs Fe Hebert School of Med, 2011

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Altru Health SystemGroup PAC ID 1355251604, 675 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Altru Hospital Hospital, Grand Forks, ND, CCN 350019

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

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.

• Altru Health System

  dba Altru 1300 Columbia

  • Clinic/Center
  • Grand Forks, ND
  • NPI 1043309552
  Medicare reassignment Care Compare group NPD
• Altru Health System

  dba Altru Care Flight

  • Ambulance
  • Grand Forks, ND
  • NPI 1114485315
  NPD

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

• Altru Health System

  • General Acute Care Hospital
  • Grand Forks, ND
  • NPI 1154346161
  Care Compare affiliation

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

{
    "created_epoch": "1303084800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1710201600000",
    "number": "1265722771",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "MIL",
            "address_1": "LANDSTUHL REGIONAL MEDICAL CENTER",
            "address_2": "UNIT 33100",
            "city": "APO",
            "state": "AE",
            "postal_code": "091803100",
            "telephone_number": "314-590-5428"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "MIL",
            "address_1": "LANDSTUHL REGIONAL MEDICAL CENTER",
            "address_2": "UNIT 33100",
            "city": "APO",
            "state": "AE",
            "postal_code": "091803100",
            "telephone_number": "314-590-5428"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ANDERSON",
        "first_name": "JACQUELINE",
        "middle_name": "ANNE",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-04-18",
        "last_updated": "2024-03-12",
        "certification_date": "2024-03-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Y00000X",
            "taxonomy_group": "",
            "desc": "Otolaryngology",
            "state": "ND",
            "license": "18224",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JACQUELINE",
            "last_name": "CHRISTENSEN",
            "middle_name": "ANNE",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 12, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.