Individual provider Active NPI

Rick Anderson, M.D.

  • Family Medicine Physician
  • Bloomington, IL
National Provider Identifier
1396772976
Registry record updated Sep 24, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
036.075884 Issued in IL
Practice address
702 W Chestnut St
Bloomington, IL 61701-2814
Phone
(309) 557-1400
NPI assigned
Jun 27, 2006
Last updated
Sep 24, 2026By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 24, 2026

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medical Services (Emergency Medicine) Physician 207PE0004X 036-075884 IL
Family Medicine Physician 207Q00000X 036.075884 IL Primary
Family Medicine Physician 207Q00000X 48214 AZ

Addresses

Primary practice location

702 W Chestnut St
Bloomington, IL 61701-2814

Mailing address

1003 Martin Luther King Dr
Bloomington, IL 61701-1429
Phone (888) 924-3786

Other practice location 1

2424 N Wyatt Dr Ste 100
Tucson, AZ 85712
Phone (520) 324-8621

Other identifiers 1

IdentifierTypeStateIssuer
947345MedicaidAZ

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL
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

Enrollment IDStateProvider typePAC IDDetails
I20050817000682 IL Practitioner - Emergency MedicinePractitioner - Family Practice 1456381656 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
036-075884ILMDEmergency Medical Services (Emergency Medicine) Physician
036.075884ILMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Chestnut Health Systems Inc. CurrentSince Jul 10, 2023 Accepting new patients
Chestnut Health Systems Inc CurrentSince Jul 10, 2023 Accepting new patients
Central PA Pharmacy LLC. Current Accepting new patients
Osf Multi-Specialty Group CurrentSince Jun 1, 2023 Accepting new patients
Prairie Emergency Group, LTD. Emergency Medical Services Past Accepting new patients
Chestnut Health Systems, Inc Past Accepting new patients
Central Illinois Neuroradiology, LTD Past Accepting new patients
Tucson Medical Center PastSince Mar 18, 2013 Accepting new patients

Locations

12 N 64th St
Belleville, IL 62223
Phone (618) 397-0900

1003 Martin Luther King Dr
Bloomington, IL 61701
Phone (309) 827-6026

1003 Martin Luther King Dr
Ste Ii
Bloomington, IL 61701

1505 Eastland Dr
Bloomington, IL 61701
Phone (309) 663-2100

1505 Eastland Dr
Ste 320
Bloomington, IL 61701
Phone (309) 661-2368

702 W Chestnut St
Bloomington, IL 61701
Phone (309) 557-1400

720 W Chestnut St
Bloomington, IL 61701
Phone (309) 557-1400

101 S Major St
Eureka, IL 61530
Phone (309) 268-2172

50 Northgate Industrial Dr
Granite City, IL 62040
Phone (618) 512-1919

2148 Vadalabene Dr
Maryville, IL 62062
Phone (618) 288-3100

448 Wylie Dr
Normal, IL 61761
Phone (844) 973-6887

8600 State Route 91
Ste 130
Peoria, IL 61615
Phone (309) 683-5050

Ownership & related parties

All facility ownership & control disclosures 2

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Tucson Medical CenterTucson, AZ, CCN 030006 Hospital Corporate Officer Mar 18, 2013
TMC HospiceTucson, AZ, CCN 031514 Hospice Corporate Officer Mar 18, 2013

Owned or controlled facilities with NPI records 2

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Organizations & group practices 8

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.

NPI Registry JSON

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

{
    "created_epoch": "1151366400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1790208000000",
    "number": "1396772976",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1003 MARTIN LUTHER KING DR",
            "city": "BLOOMINGTON",
            "state": "IL",
            "postal_code": "617011429",
            "telephone_number": "888-924-3786",
            "fax_number": "520-324-1406"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "702 W CHESTNUT ST",
            "city": "BLOOMINGTON",
            "state": "IL",
            "postal_code": "617012814",
            "telephone_number": "309-557-1400"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2424 N Wyatt Dr Ste 100",
            "address_purpose": "LOCATION",
            "city": "Tucson",
            "state": "AZ",
            "postal_code": "85712",
            "country_code": "US",
            "telephone_number": "520-324-8621",
            "fax_number": "520-324-3935",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ANDERSON",
        "first_name": "RICK",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-27",
        "last_updated": "2026-09-24",
        "certification_date": "2026-09-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207PE0004X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine, Emergency Medical Services",
            "state": "IL",
            "license": "036-075884",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "IL",
            "license": "036.075884",
            "primary": true
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "AZ",
            "license": "48214",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "947345",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Bloomington, IL

Sources for this page

Verify at the official NPI Registry.