Individual provider Active NPI

Alex Charles Anderson

  • Family Medicine Physician
  • Lebanon, OR
National Provider Identifier
1336607142
Registry record updated Jul 17, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
DO226409 Issued in OR
Practice address
200 Mullins Dr
Lebanon, OR 97355-3983
Phone
(509) 939-9846
NPI assigned
Mar 11, 2019
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 17, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Family Medicine Physician 207Q00000X DO226409 OR Primary

Addresses

Primary practice location

200 Mullins Dr
Lebanon, OR 97355-3983

Mailing address

200 Mullins Dr
Lebanon, OR 97355-3983
Phone (509) 939-9846

Other practice location 1

4010 Aerial Way
Eugene, OR 97402-9757
Phone (541) 687-6353

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250930001854 OR Practitioner - Family Practice 1355740325 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Peacehealth Medical GroupGroup PAC ID 9032023270, 256 clinicians

Practice addresses (Care Compare)

4010 Aerial Way
Eugene, OR 97402-9757
Phone (613) 272-4978

Hospital & facility affiliations

  • Sacred Heart Home Health Home health agency, Springfield, OR, CCN 387023
  • Signature Healthcare at Home Home health agency, Eugene, OR, CCN 387140
  • Sacred Heart Medical Center - Riverbend Hospital, Springfield, OR, CCN 380102

Procedures performed for Medicare patients

ProcedureNumber of procedures
Skin biopsy1-10

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Peacehealth Medical Group Family Medicine CurrentSince Sep 15, 2025 Accepting new patients

Locations

4010 Aerial Way
Eugene, OR 97402
Phone (541) 242-8300

Interoperability endpoints

  • Direct secure messaging: aanderson784243@direct.peacehealth.org

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 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": "1552262400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1752710400000",
    "number": "1336607142",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 MULLINS DR",
            "city": "LEBANON",
            "state": "OR",
            "postal_code": "973553983",
            "telephone_number": "509-939-9846"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 MULLINS DR",
            "city": "LEBANON",
            "state": "OR",
            "postal_code": "973553983",
            "telephone_number": "509-939-9846"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4010 Aerial Way",
            "address_purpose": "LOCATION",
            "city": "Eugene",
            "state": "OR",
            "postal_code": "974029757",
            "country_code": "US",
            "telephone_number": "541-687-6353",
            "fax_number": "541-242-8413",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ANDERSON",
        "first_name": "ALEX",
        "middle_name": "CHARLES",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2019-03-11",
        "last_updated": "2025-07-17",
        "certification_date": "2025-07-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "OR",
            "license": "DO226409",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lebanon, OR

Sources for this page

Verify at the official NPI Registry.