Active NPI
Charles Christian Anderson, MD
- Pediatric Cardiology Physician
- Spokane, WA
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatric Cardiology Physician
- License
- MD00041066
- Practice address
- 101 W 8TH Ave
Suite 4300
Spokane, WA 99204-2307 - Phone
- (509) 747-6707
- NPI assigned
- May 18, 2006
- 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 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Cardiac Electrophysiology Physician | 207RC0001X | MD00041066 | WA | |
| Pediatric Cardiology Physician | 2080P0202X | M-8783 | ID | |
| Pediatric Cardiology Physician | 2080P0202X | MD00041066 | WA | Primary |
Addresses
Primary practice location
101 W 8TH Ave
Suite 4300
Spokane, WA 99204-2307
Mailing address
PO Box 421
Liberty Lake, WA 99019-0421
Phone (509) 747-6707
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 806322000 | Medicaid | ID |
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | canderson219567@wm.providencedirect.org | Direct |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in WA
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Pediatric Medicine
- Education
- Baylor College of Medicine, 1993
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
200 Lilly Rd NE
Suite C
Olympia, WA 98506-5080
Phone (360) 933-0368
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Multicare Health System | Current | Accepting new patients | |
| Providence Health & Services Washington | Current | Accepting new patients | |
| Multicare Health System | Current | Accepting new patients | |
| Multicare Health System | Current | Accepting new patients | |
| Providence Health & Services - Washington | Past | Accepting new patients |
Locations
700 S Main St
Moscow, ID 83843
Phone (208) 746-7555
1200 E Columbia Ave
Colville, WA 99114
Phone (509) 684-3701
821 E Broadway Ave
Ste 5
Moses Lake, WA 98837
200 Lilly Rd NE
Ste C
Olympia, WA 98506
Phone (360) 918-8336
825 SE Bishop Blvd
Ste 140
Pullman, WA 99163
Phone (509) 334-4498
101 W 8th Ave
Ste 100
Spokane, WA 99204
Phone (509) 474-2880
101 W 8th Ave
Ste 4300
Spokane, WA 99204
Phone (509) 474-6707
101 W 8th Ave
#4300
Spokane, WA 99204
Phone (509) 747-6707
105 W 8th Ave
Ste 6045
Spokane, WA 99204
Phone (509) 455-3676
101 W 8th Ave
Spokane, WA 99204
Phone (509) 474-3181
Interoperability endpoints
- canderson219567@wm.providencedirect.org
Organizations & group practices 6
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.
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-
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NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1147910400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1617580800000",
"number": "1316990666",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 421",
"city": "LIBERTY LAKE",
"state": "WA",
"postal_code": "990190421",
"telephone_number": "509-747-6707"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "101 W 8TH AVE",
"address_2": "SUITE 4300",
"city": "SPOKANE",
"state": "WA",
"postal_code": "992042307",
"telephone_number": "509-747-6707"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ANDERSON",
"first_name": "CHARLES",
"middle_name": "CHRISTIAN",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-05-18",
"last_updated": "2021-04-05",
"certification_date": "2021-04-05",
"status": "A"
},
"taxonomies": [
{
"code": "207RC0001X",
"taxonomy_group": "",
"desc": "Internal Medicine, Clinical Cardiac Electrophysiology",
"state": "WA",
"license": "MD00041066",
"primary": false
},
{
"code": "2080P0202X",
"taxonomy_group": "",
"desc": "Pediatrics, Pediatric Cardiology",
"state": "ID",
"license": "M-8783",
"primary": false
},
{
"code": "2080P0202X",
"taxonomy_group": "",
"desc": "Pediatrics, Pediatric Cardiology",
"state": "WA",
"license": "MD00041066",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "806322000",
"state": "ID"
}
],
"endpoints": [
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "canderson219567@wm.providencedirect.org",
"affiliation": "N",
"use": "DIRECT",
"useDescription": "Direct",
"address_1": "101 W 8th Ave",
"address_2": "Suite 4300",
"city": "Spokane",
"state": "WA",
"country_code": "US",
"postal_code": "992042307",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}
Other providers in Spokane, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 5, 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.