NPIMap

Individual provider Active NPI

Debra L Anderson, DNP, FNP-C

  • Family Nurse Practitioner
  • Johnson, KS
National Provider Identifier
1306133095
Registry record updated Jul 16, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
53-77305-031 Issued in KS
Practice address
404 N Chestnut Street
Johnson, KS 67855-0639
Phone
(620) 492-1400
Fax
(620) 492-1608
NPI assigned
Jul 1, 2011
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 16, 2022

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 108186 IA
Family Nurse Practitioner 363LF0000X A-108186 IA
Family Nurse Practitioner 363LF0000X 53-77305-031 KS Primary

Addresses

Primary practice location

404 N Chestnut Street
Johnson, KS 67855-0639

Mailing address

PO Box 639
Johnson, KS 67855-0639
Phone (620) 492-1400

Other names 1

  • Debra Lee Brodersen Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KS
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20160803002914 KS Practitioner - Nurse Practitioner 1951572999 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Stanton County Hospital 4 clinicians
Decatur Health Systems Inc 11 clinicians

Practice addresses (Care Compare)

404 N Chestnut PO Box
Suite 779
Johnson, KS 67855-0779

404 N Chestnut St
Johnson, KS 67855-0639

404 N Chestnut St
Johnson, KS 67855-5001
Phone (620) 492-6250

810 W Columbia St
Oberlin, KS 67749-2450
Phone (785) 475-2208

Hospital & facility affiliations

  • Stanton County Hospital Hospital, Johnson, KS, CCN 171343
  • Bob Wilson Memorial Hospital Hospital, Ulysses, KS, CCN 171388
  • Decatur Health Hospital, Oberlin, KS, CCN 171352
  • Stanton County Hospital Nursing home, CCN 17Z343

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
108186IAMDRegistered Nurse
A-108186IAMDFamily Nurse Practitioner
53-77305-031KSMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Stanton County Hospital CurrentSince Jul 11, 2016 Accepting new patients
Decatur Health Systems Inc CurrentSince Mar 1, 2025 Accepting new patients
Stanton County Hospital Current Accepting new patients
Decatur Health Systems Inc CurrentSince Mar 1, 2025 Accepting new patients
Stanton County Hospital Past Accepting new patients

Locations

810 W Columbia St
Oberlin, KS 67749
Phone (785) 475-2200

902 W Columbia St
Oberlin, KS 67749
Phone (785) 475-2221

Organizations & group practices 7

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.

Hospital & facility affiliations 4

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

NPI Registry JSON

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

{
    "created_epoch": "1309478400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1657929600000",
    "number": "1306133095",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 639",
            "city": "JOHNSON",
            "state": "KS",
            "postal_code": "678550639",
            "telephone_number": "620-492-1400",
            "fax_number": "620-492-1608"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "404 N CHESTNUT STREET",
            "city": "JOHNSON",
            "state": "KS",
            "postal_code": "678550639",
            "telephone_number": "620-492-1400",
            "fax_number": "620-492-1608"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ANDERSON",
        "first_name": "DEBRA",
        "middle_name": "L",
        "name_prefix": "Dr.",
        "credential": "DNP, FNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-07-01",
        "last_updated": "2022-07-16",
        "certification_date": "2022-07-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "IA",
            "license": "108186",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "IA",
            "license": "A-108186",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "KS",
            "license": "53-77305-031",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "DEBRA",
            "last_name": "BRODERSEN",
            "middle_name": "LEE",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Johnson, KS

Sources for this page

Verify at the official NPI Registry.