Individual provider Active NPI

Christopher J Anderson, NP

  • Dermatology Physician
  • Savannah, GA
National Provider Identifier
1376651026
Registry record updated Mar 31, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dermatology PhysicianTaxonomy code 207N00000X
License
RN105862 Issued in GA
Practice address
900 Mohawk St Ste E
Savannah, GA 31419-1768
Phone
(912) 925-0067
Fax
(912) 927-0267
NPI assigned
Aug 25, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 31, 2021

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

Specialties & licenses 8

Specialty (taxonomy)CodeLicenseStatePrimary
Dermatology Physician 207N00000X APN2728 SC
Pediatric Dermatology Physician 207NP0225X APN2728 SC
Pediatric Dermatology Physician 207NP0225X RN105862 GA
Procedural Dermatology Physician 207NS0135X APN2728 SC
Procedural Dermatology Physician 207NS0135X RN105862 GA
Adult Health Nurse Practitioner 363LA2200X RN105862 GA
Adult Health Nurse Practitioner 363LA2200X APN2728 SC
Dermatology Physician 207N00000X RN105862 GA Primary

Addresses

Primary practice location

900 Mohawk St Ste E
Savannah, GA 31419-1768

Mailing address

900 Mohawk St Ste E
Savannah, GA 31419-1768
Phone (912) 925-0067

Other identifiers 5

IdentifierTypeStateIssuer
837663219BMedicaidGA
837663219AMedicaidGA
837663219CMedicaidGA
NP0945MedicaidSC
837663219DMedicaidGA

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address canderson@gscc.encitedirect.com

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in SC, GA2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20051010000776 SC Practitioner - Nurse Practitioner 1557386414 Reassigns benefits to 1 organization
I20100824000833 GA Practitioner - Nurse Practitioner 1557386414 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2003
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Sidney P Smith MD PCGroup PAC ID 0042206807, 20 clinicians

Practice addresses (Care Compare)

176 Dermis Ave
Hardeeville, SC 29927-4161
Phone (843) 208-2055

900 Mohawk St
Suite E
Savannah, GA 31419-1768
Phone (912) 925-0067

900 Mohawk St E
Savannah, GA 31419-1768

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
40.13 of 100Reported as individual
Quality
29.56
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
2728SCMDChiropractor
APN2728SCMDPediatric Dermatology Physician
RN105862GAMDAdult Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Sidney P Smith MD PC Dermatology CurrentSince Oct 1, 2003 Accepting new patients

Locations

19 Brobston St
Ste B
Baxley, GA 31513

6677 Highway 67
Brooklet, GA 30415
Phone (912) 350-2700

3215 Shrine Rd
Ste 2
Brunswick, GA 31520
Phone (912) 262-0042

800 Towne Park Dr
Ste 400
Rincon, GA 31326
Phone (912) 826-1220

900 Mohawk St
Savannah, GA 31419
Phone (912) 920-2090

900 Mohawk St
Ste E
Savannah, GA 31419

1504 Tebeau St
Waycross, GA 31501

176 Dermis Ave
Hardeeville, SC 29927
Phone (843) 208-2055

Interoperability endpoints

  • Direct secure messaging: canderson@gscc.encitedirect.com

Organizations & group practices 1

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.

Hospital & facility affiliations 2

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

NPI Registry JSON

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

{
    "created_epoch": "1156464000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1617148800000",
    "number": "1376651026",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "900 MOHAWK ST STE E",
            "city": "SAVANNAH",
            "state": "GA",
            "postal_code": "314191768",
            "telephone_number": "912-925-0067",
            "fax_number": "912-927-0267"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "900 MOHAWK ST STE E",
            "city": "SAVANNAH",
            "state": "GA",
            "postal_code": "314191768",
            "telephone_number": "912-925-0067",
            "fax_number": "912-927-0267"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ANDERSON",
        "first_name": "CHRISTOPHER",
        "middle_name": "J",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-25",
        "last_updated": "2021-03-31",
        "certification_date": "2021-03-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "SC",
            "license": "APN2728",
            "primary": false
        },
        {
            "code": "207NP0225X",
            "taxonomy_group": "",
            "desc": "Dermatology, Pediatric Dermatology",
            "state": "SC",
            "license": "APN2728",
            "primary": false
        },
        {
            "code": "207NP0225X",
            "taxonomy_group": "",
            "desc": "Dermatology, Pediatric Dermatology",
            "state": "GA",
            "license": "RN105862",
            "primary": false
        },
        {
            "code": "207NS0135X",
            "taxonomy_group": "",
            "desc": "Dermatology, Procedural Dermatology",
            "state": "SC",
            "license": "APN2728",
            "primary": false
        },
        {
            "code": "207NS0135X",
            "taxonomy_group": "",
            "desc": "Dermatology, Procedural Dermatology",
            "state": "GA",
            "license": "RN105862",
            "primary": false
        },
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "GA",
            "license": "RN105862",
            "primary": false
        },
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "SC",
            "license": "APN2728",
            "primary": false
        },
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "GA",
            "license": "RN105862",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "837663219B",
            "state": "GA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "837663219A",
            "state": "GA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "837663219C",
            "state": "GA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "NP0945",
            "state": "SC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "837663219D",
            "state": "GA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "canderson@gscc.encitedirect.com",
            "affiliation": "N",
            "address_1": "900 Mohawk St Ste E",
            "city": "Savannah",
            "state": "GA",
            "country_code": "US",
            "postal_code": "314191768",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Savannah, GA

Sources for this page

Verify at the official NPI Registry.