Kathy J Anderson, M.D.

Primary specialty

General Practice PhysicianTaxonomy code 208D00000X

License

22911 Issued in IA

Practice address

5409 Avenue O
Fort Madison, IA 52627-9601

Phone

(319) 376-2134

Fax

(319) 376-2188

NPI assigned

Aug 11, 2005

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 identifiers 5

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Specialty

General Practice

Education

University of Wisconsin School of Medicine, 1979

Medicare assignment

May accept Medicare assignment

Practice addresses (Care Compare)

Hospital & facility affiliations

• Southeast Iowa Regional Home Health Home health agency, West Burlington, IA, CCN 167136
• Southeast Iowa Regional Hospice Hospice, West Burlington, IA, CCN 161567
• Southeast Iowa Regional Medical Center Hospital, West Burlington, IA, CCN 160057
• Henry County Health Center Hospital, Mount Pleasant, IA, CCN 161356

Merit-based Incentive Payment System (MIPS)

Final score

77.06 of 100Reported as group

Quality

64.36

Promoting interoperability

81

Improvement activities

40

Cost

75.01

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: kathy.anderson@direct.greatriverhealth.org

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

• Southeast Iowa Regional Medical Center, Inc.

  dba Southeast Iowa Regional Medical Center

  • General Practice Physician
  • West Burlington, IA
  • NPI 1164433884
  NPD
• Southeast Iowa Regional Medical Center, Inc.

  dba Great River Home Health and Hospice

  • Home Health Agency
  • West Burlington, IA
  • NPI 1760461644
  NPD (past)

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

• Henry County Health Center, Inc.

  • Critical Access Hospital
  • Mt Pleasant, IA
  • NPI 1811571417
  Care Compare affiliation
• Southeast Iowa Regional Medical Center, Inc.

  dba Great River Home Health and Hospice

  • Community Based Hospice Care Agency
  • West Burlington, IA
  • NPI 1053315002
  Care Compare affiliation
• Southeast Iowa Regional Medical Center, Inc.

  dba Southeast Iowa Regional Medical Center

  • General Acute Care Hospital
  • West Burlington, IA
  • NPI 1134168263
  Care Compare affiliation
• Southeast Iowa Regional Medical Center, Inc.

  dba Great River Home Health and Hospice

  • Home Health Agency
  • West Burlington, IA
  • NPI 1760461644
  Care Compare affiliation

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

{
    "created_epoch": "1123718400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1619481600000",
    "number": "1285636100",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5409 AVENUE O",
            "city": "FORT MADISON",
            "state": "IA",
            "postal_code": "526279601",
            "telephone_number": "319-376-2134",
            "fax_number": "319-376-2188"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5409 AVENUE O",
            "city": "FORT MADISON",
            "state": "IA",
            "postal_code": "526279601",
            "telephone_number": "319-376-2134",
            "fax_number": "319-376-2188"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ANDERSON",
        "first_name": "KATHY",
        "middle_name": "J",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-08-11",
        "last_updated": "2021-04-27",
        "certification_date": "2021-04-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "IA",
            "license": "22911",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1194910",
            "state": "IA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "WELLMARK/BLUE CROSS",
            "identifier": "45019",
            "state": "IA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "080122362",
            "state": "IA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "JOHN DEERE HEALTH CARE",
            "identifier": "IA0121",
            "state": "IA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "IOWA HEALTH SOLUTIONS",
            "identifier": "25671",
            "state": "IA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "kathy.anderson@Direct.greatriverhealth.org",
            "affiliation": "N",
            "endpointDescription": "Great River Health Direct Email Address",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "CCDA",
            "address_1": "5409 Avenue O",
            "city": "Fort Madison",
            "state": "IA",
            "country_code": "US",
            "postal_code": "526279601",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Alcohol & Drug Dependency Services of SE Iowa
• American Eyecare PC
• Cristina A Andia Rabo, MD
• Garrett Benjamin Anthony, MA, LMHC
• Arhc Smmdsia01 TRS, LLC (Addington Place of Fort Madison)
• Wesley Riggs Bagan, M.D.
• Ruth Barosy, M.D.

• General Practice Physician in Fort Madison, IA
• Providers in Fort Madison, IA by specialty
• General Practice Physician in Iowa

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 27, 2021; 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.