Individual provider Active NPI

Robert Dana Anderson, DC

  • Chiropractor
  • Kennewick, WA
National Provider Identifier
1366540445
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
CH00001583 Issued in WA
Practice address
7103 W Grandridge Blvd
Suite #B
Kennewick, WA 99336-6713
Phone
(509) 783-7363
Fax
(509) 783-0329
NPI assigned
Sep 20, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X CH00001583 WA Primary

Addresses

Primary practice location

7103 W Grandridge Blvd
Suite #B
Kennewick, WA 99336-6713

Mailing address

7103 W Grandridge Blvd
Suite #B
Kennewick, WA 99336-6713
Phone (509) 783-7363

Other identifiers 1

IdentifierTypeStateIssuer
17579OtherWALABOR & INDUSTIRES

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
CH00001583WAMDChiropractor

NPI Registry JSON

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

{
    "created_epoch": "1158710400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1366540445",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7103 W GRANDRIDGE BLVD",
            "address_2": "SUITE #B",
            "city": "KENNEWICK",
            "state": "WA",
            "postal_code": "993366713",
            "telephone_number": "509-783-7363",
            "fax_number": "509-783-0329"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7103 W GRANDRIDGE BLVD",
            "address_2": "SUITE #B",
            "city": "KENNEWICK",
            "state": "WA",
            "postal_code": "993366713",
            "telephone_number": "509-783-7363",
            "fax_number": "509-783-0329"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ANDERSON",
        "first_name": "ROBERT",
        "middle_name": "DANA",
        "name_prefix": "Mr.",
        "credential": "DC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-20",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "WA",
            "license": "CH00001583",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LABOR & INDUSTIRES",
            "identifier": "17579",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Kennewick, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.