Koby Anderson, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

2475 Issued in OK

Practice address

3110 SW 89TH St Ste 200E
Oklahoma City, OK 73159-7919

Phone

(405) 486-6720

NPI assigned

Dec 23, 2014

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in OK

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Physician Assistant

Education

Other, 2014

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Hpi Physicians LLCGroup PAC ID 6406048289, 48 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Community Hospital, LLC Hospital, Oklahoma City, OK, CCN 370203

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Interoperability endpoints

• Direct secure messaging: koby.anderson.p4@direct.athleticoltd.nextgenshare.com
• Direct secure messaging: kanderson454439@direct.integrisok.com

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.

• Hpi Physicians LLC

  • General Practice Physician
  • Edmond, OK
  • NPI 1205152600

  OK

  Medicare reassignment Care Compare group
• Laser Spine Institute of Arizona, LLC

  • Specialist
  • Scottsdale, AZ
  • NPI 1174778484
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Community Hospital LLC

  • General Acute Care Hospital
  • Oklahoma City, OK
  • NPI 1275593337

  Hospital

  Care Compare affiliation

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1419292800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1581552000000",
    "number": "1356739486",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3110 SW 89TH ST STE 200E",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "731597919",
            "telephone_number": "405-486-6720"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3110 SW 89TH ST STE 200E",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "731597919",
            "telephone_number": "405-486-6720"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ANDERSON",
        "first_name": "KOBY",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-12-23",
        "last_updated": "2020-02-13",
        "certification_date": "2020-02-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "IA",
            "license": "076350",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "OK",
            "license": "2475",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI",
            "identifier": "1356739486",
            "state": "OK"
        }
    ],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "Unknown",
            "affiliation": "N",
            "address_1": "3110 SW 89th St Ste 200E",
            "city": "Oklahoma City",
            "state": "OK",
            "country_code": "US",
            "postal_code": "731597919",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Kathryn Lynn Anderson, APRN
• Kayla Pearl Cox Anderson, D.PH.
• Kelley Anderson
• Kelsey Anderson
• Kimberly Millicent Anderson, M.ED
• Kristen Anderson, LPC
• Kyle J Anderson
• La Donna Grace Anderson, MS REHAB. COUNSELING
• Lacie Jai Anderson, LPN
• Latoya Rena Anderson

• Physician Assistant in Oklahoma City, OK
• Providers in Oklahoma City, OK by specialty
• Physician Assistant in Oklahoma

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 13, 2020; 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.

Verify at the official NPI Registry.