NPIMap

Individual provider Active NPI

David James Anderson, MD

  • Pediatric Orthopaedic Surgery Physician
  • Saint Louis, MO
National Provider Identifier
1306802343
Registry record updated Aug 28, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Orthopaedic Surgery PhysicianTaxonomy code 207XP3100X
License
R5J26 Issued in MO
Practice address
621 S New Ballas Rd Ste 63B
Saint Louis, MO 63141-8251
Phone
(314) 983-4700
Fax
(314) 692-9862
NPI assigned
Apr 26, 2006
Last updated
Aug 28, 2013By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 28, 2013

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Orthopaedic Surgery Physician 207X00000X R5J26 MO
Pediatric Orthopaedic Surgery Physician 207XP3100X R5J26 MO Primary

Addresses

Primary practice location

621 S New Ballas Rd Ste 63B
Saint Louis, MO 63141-8251

Mailing address

12639 Old Tesson Rd Ste 115
Saint Louis, MO 63128-2786
Phone (314) 849-0311

Other identifiers 2

IdentifierTypeStateIssuer
202685533MedicaidMO
100446480AMedicaidKS

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MO
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
I20070607000240 MO Practitioner - Orthopedic SurgeryPractitioner - Pediatric Medicine 1254439771 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Orthopedic SurgeryAlso: Pediatric Medicine
Education
Saint Louis University School of Medicine, 1983
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Mercy Clinic Childrens Surgery LLCGroup PAC ID 4385076199, 3 clinicians

Practice addresses (Care Compare)

621 S New Ballas Rd
Suite 63B
Saint Louis, MO 63141-8251
Phone (314) 966-0111

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
R5J26MOMDOrthopaedic Surgery Physician
2005004124MOMDUrology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Mercy Clinic Children's Surgery, LLC CurrentSince Sep 9, 2019 Accepting new patients
Mercy Hospitals East Communities CurrentSince May 19, 2019 Accepting new patients
Mercy Hospitals East Communities CurrentSince May 19, 2019 Accepting new patients
Gibson Community Hospital Association Past Accepting new patients
Ozarks Medical Center Past Accepting new patients

Locations

615 S New Ballas Rd
Saint Louis, MO 63141
Phone (314) 251-4687

621 S New Ballas Rd
Ste 63B
Saint Louis, MO 63141
Phone (314) 251-3500

Interoperability endpoints

  • Direct secure messaging: danderson99574@directc.mercy.net

Organizations & group practices 5

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.

Hospital & facility affiliations 2

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": "1146009600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1377648000000",
    "number": "1306802343",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12639 OLD TESSON RD STE 115",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631282786",
            "telephone_number": "314-849-0311",
            "fax_number": "314-849-4423"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "621 S NEW BALLAS RD STE 63B",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631418251",
            "telephone_number": "314-983-4700",
            "fax_number": "314-692-9862"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ANDERSON",
        "first_name": "DAVID",
        "middle_name": "JAMES",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-04-26",
        "last_updated": "2013-08-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": "MO",
            "license": "R5J26",
            "primary": false
        },
        {
            "code": "207XP3100X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery, Pediatric Orthopaedic Surgery",
            "state": "MO",
            "license": "R5J26",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "202685533",
            "state": "MO"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100446480A",
            "state": "KS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Saint Louis, MO

Sources for this page

Verify at the official NPI Registry.