Richard D. Anderson, M.D.
Individual provider Active NPI Internal Medicine Physician · Cody, WY
NPI 1346288263 · NPPES record last updated Oct 5, 2011
Key facts
- NPI
- 1346288263
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Internal Medicine Physician 207R00000X
- License
- 2329A (WY)
- Practice address
- 424 Yellowstone Ave Ste 230
Cody, WY 82414 - Phone
- (307) 578-2975
- Fax
- (307) 578-2979
- NPI assigned
- Jun 3, 2006
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 2
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in WY
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20080626000331 | WY | Practitioner - Internal Medicine | 6608948229 |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 6350 | MT | MD | Internal Medicine Physician |
| 2329A | WY | MD | Internal Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Signify Health Medical Associates, PLLC | Current |
Accepting new patients | |
| Frances Mahon Deaconess Hospital | Past | Accepting new patients |
Locations
4055 Valley View Ln
Ste 400
Dallas, TX 75244
Phone (469) 466-7037
1908 Thomes Ave
Cheyenne, WY 82001
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Internal Medicine Physician | 207R00000X | 6350 | MT | |
| Internal Medicine Physician | 207R00000X | 2329A | WY | Yes |
Addresses
Primary practice location
424 Yellowstone Ave Ste 230
Cody, WY 82414
Mailing address
707 Sheridan Ave
Cody, WY 82414
Phone (307) 578-2480
Other providers in Cody, WY
- Amanda Roth, LLC
- Christina Maria Amarillas
- Amanda Ambrose
- Tracey Ambrose
- Aidan Amtmann
- Carolyn Elaine Andrews
- Larry J Andrews
- Brittany Asay
- Levi Asay
- Aspen Counseling Services LLC
All providers in Cody, WY · Internal Medicine Physician in Wyoming
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Oct 5, 2011. 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).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.