Kenneth R Anderson, D.O.

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

01931 Issued in IA

Practice address

1200 N 7TH St
Chariton, IA 50049-1210

Phone

(641) 774-8103

Fax

(641) 774-8087

NPI assigned

Jan 19, 2006

Last updated

Feb 8, 2012By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 7

Medicare fee-for-service enrollment

Enrolled in IA

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

Geriatric Medicine

Education

At Still University of Health Sciences, College of Osteo Med, Kirksville, 1981

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Lucas County Health CenterGroup PAC ID 8921916792, 33 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Elara Caring Home health agency, Chariton, IA, CCN 167293
• Lucas County Health Center Hospital, Chariton, IA, CCN 161341

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: kanderson556452@direct.unitypoint.org

All facility ownership & control disclosures 3

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

Owned or controlled facilities with NPI records 3

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

• Lucas County Health Center

  dba Lucas County Health Center Medical Clinic

  • Rural Health Clinic/Center
  • Chariton, IA
  • NPI 1538466842

  Corporate Officer, W-2 Managing Employee

  CMS ownership
• Lucas County Health Center

  • Critical Access Hospital
  • Chariton, IA
  • NPI 1588636351

  Corporate Officer, W-2 Managing Employee

  CMS ownership
• Lucas County Health Center

  • Medicare Defined Swing Bed Hospital Unit
  • Chariton, IA
  • NPI 1912970401

  Corporate Officer, W-2 Managing Employee

  CMS ownership

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.

• Lucas County Health Center

  • Critical Access Hospital
  • Chariton, IA
  • NPI 1588636351
  Medicare reassignment Care Compare group NPD
• Lucas County Health Center

  dba Lucas County Health Center Medical Clinic

  • Rural Health Clinic/Center
  • Chariton, IA
  • NPI 1538466842

  Family Medicine

  NPD
• Lucas County Heatlh Center

  dba Lucas County Health Center Surgical Group

  • Surgery Physician
  • Chariton, IA
  • NPI 1003210824
  NPD
• St Luke's Methodist Hospital

  • General Acute Care Hospital
  • Cedar Rapids, IA
  • NPI 1083708226
  NPD

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

• Caregivers of Chariton, LLC

  • Home Health Agency
  • Chariton, IA
  • NPI 1558847749
  Care Compare affiliation
• Lucas County Health Center

  • Critical Access Hospital
  • Chariton, IA
  • NPI 1588636351
  Care Compare affiliation

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

{
    "created_epoch": "1137628800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1328659200000",
    "number": "1275513756",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1200 N 7TH ST",
            "city": "CHARITON",
            "state": "IA",
            "postal_code": "500491210",
            "telephone_number": "641-774-8103",
            "fax_number": "641-774-8087"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1200 N 7TH ST",
            "city": "CHARITON",
            "state": "IA",
            "postal_code": "500491210",
            "telephone_number": "641-774-8103",
            "fax_number": "641-774-8087"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ANDERSON",
        "first_name": "KENNETH",
        "middle_name": "R",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-01-19",
        "last_updated": "2012-02-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "IA",
            "license": "01931",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "5193557",
            "state": "IA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "WELLMARK",
            "identifier": "1275513756",
            "state": "IA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1275513756",
            "state": "IA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "40870",
            "state": "IA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TRAVELERS MEDICARE",
            "identifier": "110153091",
            "state": "IA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "40871",
            "state": "IA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4193557",
            "state": "IA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Care Initiatives (Chariton Specialty)

• Family Medicine Physician in Chariton, IA
• Providers in Chariton, IA by specialty
• Family Medicine Physician in Iowa

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 8, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; facility enrollments, owners and changes of ownership; Provider of Services certification data; 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.