Dr. John Anderson

Primary specialty

DentistTaxonomy code 122300000X

License

D3022 Issued in AL

Legal business name

DR. JOHN ANDERSON

Practice address

89 Church Ave
Rainsville, AL 35986-0646

Phone

(256) 638-4436

Fax

(256) 638-7212

NPI assigned

May 10, 2016

Last updated

May 10, 2016By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. John P Anderson Jr., DMDNPI 1700945631

Title

Owner

Phone

(256) 638-4436

Specialties & licenses 1

Addresses

Other identifiers 1

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• John Pershing Anderson Jr., DMD

  • Dentist
  • Rainsville, AL
  • NPI 1700945631
  NPD (past) Authorized official

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

{
    "created_epoch": "1462838400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1462838400000",
    "number": "1407202476",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "89 CHURCH AVE",
            "address_2": "PO BOX 646",
            "city": "RAINSVILLE",
            "state": "AL",
            "postal_code": "359860646",
            "telephone_number": "256-638-4436",
            "fax_number": "256-638-7212"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "89 CHURCH AVE",
            "city": "RAINSVILLE",
            "state": "AL",
            "postal_code": "359860646",
            "telephone_number": "256-638-4436",
            "fax_number": "256-638-7212"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DR. JOHN ANDERSON",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-05-10",
        "last_updated": "2016-05-10",
        "status": "A",
        "authorized_official_last_name": "ANDERSON",
        "authorized_official_first_name": "JOHN",
        "authorized_official_middle_name": "P",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "256-638-4436",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_name_suffix": "Jr.",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "AL",
            "license": "D3022",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "90122",
            "state": "AL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Dentist in Rainsville, AL
• Providers in Rainsville, AL by specialty
• Dentist in Alabama

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 10, 2016; 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.