Jonathan Edward Anderson, M.D.

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

MD177500 Issued in OR

Practice address

1750 Thompson Rd
Coos Bay, OR 97420-2100

Phone

(541) 269-0333

Fax

(541) 269-7389

NPI assigned

Aug 30, 2013

Last updated

Oct 4, 2016By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

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

Specialty

Pediatric Medicine

Education

Loma Linda University School of Medicine, 2013

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Bay ClinicGroup PAC ID 9638164874, 13 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://fhir-myrecord.cerner.com/r4/bea62b1d-5b0c-4c1a-bdbd-eaa129312421/
• Direct secure messaging: janderson128476@secure.stcharleshealthcare.org

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Bay Clinic

  • Specialist
  • Coos Bay, OR
  • NPI 1538174958
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1377820800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1475539200000",
    "number": "1356775969",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1750 THOMPSON RD",
            "city": "COOS BAY",
            "state": "OR",
            "postal_code": "974202100",
            "telephone_number": "541-269-0333",
            "fax_number": "541-269-7389"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1750 THOMPSON RD",
            "city": "COOS BAY",
            "state": "OR",
            "postal_code": "974202100",
            "telephone_number": "541-269-0333",
            "fax_number": "541-269-7389"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ANDERSON",
        "first_name": "JONATHAN",
        "middle_name": "EDWARD",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-08-30",
        "last_updated": "2016-10-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "OR",
            "license": "MD177500",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Sonia Amlin, MS
• John A Ammon, MA, QMHP
• Tracy Lynne Amonoo, NP, CNM
• Amy Anderson, RDH
• David Craig Anderson
• Judith Lawrence Anderson, MA, LPC, ATR
• Katlin Rene Anderson, DPT
• Malias Andrews
• Regina M Ardiana, FNPC
• Allison Arends, NP

• Pediatrics Physician in Coos Bay, OR
• Providers in Coos Bay, OR by specialty
• Pediatrics Physician in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 4, 2016; 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.