John Anderson, MSN, FNP-BC
Individual provider Active NPI Family Nurse Practitioner · Prospect, CT
NPI 1326835513 · NPPES record last updated Aug 21, 2025
Key facts
- NPI
- 1326835513
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Family Nurse Practitioner 363LF0000X
- License
- 12.015031 (CT)
- Practice address
- 115 Waterbury Rd Ste 1
Prospect, CT 06712-1254 - Phone
- (203) 758-5660
- NPI assigned
- Apr 22, 2025
- Sex
- Male
- Sole proprietor
- Yes
Organizations & group practices 1
Medicare Care Compare profile
- Specialty
- Nurse Practitioner
- Education
- Other, 2025
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Prohealth Physicians PC
Practice addresses (Care Compare)
115 Waterbury Rd
Prospect, CT 06712-1254
Phone (203) 758-5660
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in CT
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20250918003320 | CT | Practitioner - Nurse Practitioner | 3971007212 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Master of Science - Nursing, Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 15031 | CT | MD | Physical Therapist |
| 12.015031 | CT | MD | Family Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Prohealth Physicians PC | Family | Current |
Accepting new patients |
Locations
3 Farm Glen Blvd
Farmington, CT 06032
Phone (860) 284-5200
115 Waterbury Rd
Prospect, CT 06712
Phone (203) 758-5660
115 Waterbury Rd
Ste 1
Prospect, CT 06712
Phone (203) 527-5871
115 Spencer St
Winsted, CT 06098
Phone (860) 738-5810
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Nurse Practitioner | 363LF0000X | 12.015031 | CT | Yes |
Addresses
Primary practice location
115 Waterbury Rd Ste 1
Prospect, CT 06712-1254
Mailing address
115 Waterbury Rd Ste 1
Prospect, CT 06712-1254
Phone (203) 758-5660
Other providers in Prospect, CT
- 203 Psychiatry LLC
- Carlos S Almeida
- Alexander J Alvarez
- Jenny Amos-Afful
- Brittany Andreoli
- Sharon Anita Anthony
- Dasha Arsenault
- Nicole Attwood
- Jeremy August
All providers in Prospect, CT · Family Nurse Practitioner in Connecticut
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 21, 2025. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.