Active NPI
Robert Dana Anderson, DC
- Chiropractor
- Kennewick, WA
National Provider Identifier
1366540445
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Chiropractor
- License
- CH00001583
- 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
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| 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
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 17579 | Other | WA | LABOR & 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
| License | State | Type | Specialty |
|---|---|---|---|
| CH00001583 | WA | MD | Chiropractor |
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.