Active NPI
Scott Anderson, M.D.
- Internal Medicine Physician
- Hazelwood, MO
National Provider Identifier
1316938764
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Internal Medicine Physician
- License
- R9D52
- Practice address
- 637 Dunn Rd Ste 170
Hazelwood, MO 63042-1759 - Phone
- (314) 838-5702
- Fax
- (314) 839-5596
- NPI assigned
- Nov 3, 2005
- Last updated
- Feb 8, 2019
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Internal Medicine Physician | 207R00000X | G57847 | CA | |
| Internal Medicine Physician | 207R00000X | R9D52 | MO | Primary |
Addresses
Primary practice location
637 Dunn Rd Ste 170
Hazelwood, MO 63042-1759
Mailing address
PO Box 23340
Saint Louis, MO 63156-3340
Phone (314) 838-5702
Other identifiers 7
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 4000029 | Other | MO | AETNA |
| 127461 | Other | MO | GHP |
| 100161 | Other | MO | HEALTHLINK |
| 0400431 | Other | MO | UHC |
| 00000010007 | Other | MO | ESSENCE |
| 28771 | Other | MO | BCBS |
| A13912 | Other | MO | MERCY |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| G57847 | CA | MD | Internal Medicine Physician |
| R9D52 | MO | MD | Internal Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Ozarks Medical Center | Past | Accepting new patients |
Interoperability endpoints
- scott.anderson.p1@direct.phcenters.nextgenshare.com
Organizations & group practices 1
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.
-
dba Ozarks Healthcare
- General Acute Care Hospital
- West Plains, MO
- NPI 1831115641
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1130976000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1549584000000",
"number": "1316938764",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 23340",
"city": "SAINT LOUIS",
"state": "MO",
"postal_code": "631563340",
"telephone_number": "314-838-5702",
"fax_number": "314-839-5596"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "637 DUNN RD STE 170",
"city": "HAZELWOOD",
"state": "MO",
"postal_code": "630421759",
"telephone_number": "314-838-5702",
"fax_number": "314-839-5596"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ANDERSON",
"first_name": "SCOTT",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2005-11-03",
"last_updated": "2019-02-08",
"status": "A"
},
"taxonomies": [
{
"code": "207R00000X",
"taxonomy_group": "",
"desc": "Internal Medicine",
"state": "CA",
"license": "G57847",
"primary": false
},
{
"code": "207R00000X",
"taxonomy_group": "",
"desc": "Internal Medicine",
"state": "MO",
"license": "R9D52",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "AETNA",
"identifier": "4000029",
"state": "MO"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "GHP",
"identifier": "127461",
"state": "MO"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "HEALTHLINK",
"identifier": "100161",
"state": "MO"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "UHC",
"identifier": "0400431",
"state": "MO"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "ESSENCE",
"identifier": "00000010007",
"state": "MO"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BCBS",
"identifier": "28771",
"state": "MO"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MERCY",
"identifier": "A13912",
"state": "MO"
}
],
"endpoints": [],
"other_names": []
}
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- Jonathon L Anderson, PHARMD.
- Angel Wings Nursing Services LLC
- Angels of Mercy Healthcare, Inc.
- Anointed Seasoned Adults
- Kelsey Lynne Anstandig, DPT
- Bryant Antoine
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 8, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.