Violet Anderson, CRNP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

SP021609 Issued in PA

Practice address

2338 S Broad St
Philadelphia, PA 19145-4450

Phone

(215) 764-2643

NPI assigned

Oct 15, 2020

Last updated

Oct 15, 2020By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

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.

• Primary Homecare, LLC

  • Primary Care Nurse Practitioner
  • Elkins Park, PA
  • NPI 1629023593
  NPD

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

{
    "created_epoch": "1602720000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1602720000000",
    "number": "1407454051",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2053 MCCLELLAN ST",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191452026",
            "telephone_number": "610-608-1820"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2338 S BROAD ST",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191454450",
            "telephone_number": "215-764-2643"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ANDERSON",
        "first_name": "VIOLET",
        "credential": "CRNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-10-15",
        "last_updated": "2020-10-15",
        "certification_date": "2020-10-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "PA",
            "license": "SP021609",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "Axxess",
            "affiliation": "N",
            "address_1": "2338 S Broad St",
            "city": "Philadelphia",
            "state": "PA",
            "country_code": "US",
            "postal_code": "191454450",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Shanada Yjan Anderson, MS
• Sheila Anderson
• Sonja Anderson, CRNP
• Suzanne Banning Anderson, LCSW
• Terry M Anderson, M.D.
• Wendy Anderson
• Elizabeth Andes, M.D.
• Ricca Aimee Ando, DO
• Nicole Dorothee Andorko, PH.D.
• Andorra Family Dentistry PC

• Family Nurse Practitioner in Philadelphia, PA
• Providers in Philadelphia, PA by specialty
• Family Nurse Practitioner in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 15, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.