NPIMap

Individual provider Active NPI

Halley C Anderson, DO

  • Geriatric Medicine (Family Medicine) Physician
  • Quincy, IL
National Provider Identifier
1427495803
Registry record updated Jan 19, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Geriatric Medicine (Family Medicine) PhysicianTaxonomy code 207QG0300X
License
036143810 Issued in IL
Practice address
1025 Maine St
Quincy, IL 62301-4038
Phone
(217) 222-6550
Fax
(217) 277-2253
NPI assigned
May 26, 2013
Last updated
Jan 19, 2018By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 19, 2018

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 036143810 IL
Geriatric Medicine (Family Medicine) Physician 207QG0300X 036143810 IL Primary

Addresses

Primary practice location

1025 Maine St
Quincy, IL 62301-4038

Mailing address

1025 Maine St
Quincy, IL 62301-4038
Phone (217) 222-6550

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL, IA, MO3 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 3

Enrollment IDStateProvider typePAC IDDetails
I20170928002939 IL Practitioner - Geriatric Medicine 8628219672 Reassigns benefits to 2 organizations
I20171205002141 IA Practitioner - Geriatric MedicinePractitioner - Family Practice 8628219672 Reassigns benefits to 1 organization
I20180918000220 MO Practitioner - Geriatric Medicine 8628219672 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Geriatric MedicineAlso: Family Practice
Education
Other, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

1025 Maine St
Quincy, IL 62301-4038
Phone (217) 222-6550

1025 Maine St
Quincy, IL 62301-4096

1603 Morgan St
Keokuk, IA 52632-3433
Phone (319) 524-4300

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
036143810ILMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
St Luke's Methodist Hospital Current Accepting new patients
Quincy Physicians & Surgeons Clinic, PLLC CurrentSince Sep 1, 2017 Accepting new patients
Quincy Physicians & Surgeons Clinic, PLLC CurrentSince Dec 1, 2017 Accepting new patients
Quincy Physicians & Surgeons Clinic, PLLC CurrentSince Sep 1, 2017 Accepting new patients
Quincy Physicians & Surgeons Clinic, PLLC Past Accepting new patients
Lewis County Nursing Home District Past Accepting new patients
Labelle Manor Inc Past Accepting new patients
Country Aire Healthcare LLC Past Accepting new patients
Lexington Square LLC Past Accepting new patients

Locations

1603 Morgan St
Ste 3
Keokuk, IA 52632
Phone (319) 524-3796

1025 Maine St
Quincy, IL 62301
Phone 21722265503163

1707 N 12th St
#29M
Quincy, IL 62301
Phone (217) 222-8641

1707 N 12th St
Bldg 29M
Quincy, IL 62301
Phone (217) 222-8641

17528 State Highway 81
Canton, MO 63435
Phone (573) 288-4454

Interoperability endpoints

  • Direct secure messaging: handerson207109@direct.unitypoint.org

Ownership & related parties

All facility ownership & control disclosures 3

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

FacilityTypeRoleSince
Mississippi Valley Healthcare & Rehabilitation CenterKeokuk, IA, CCN 165151 Skilled nursing facility Managing Control - Governing Body
Adp of the SNF		 Oct 18, 2023
Apr 17, 2025
Good Samaritan Home of QuincyQuincy, IL, CCN 145773 Skilled nursing facility Operational/Managerial Control
Adp of the SNF		 Jun 12, 2017
Feb 6, 2025
Southeast Iowa Healthcare CenterKeokuk, IA, CCN 165797 Skilled nursing facility Adp of the SNF Oct 18, 2023

Owned or controlled facilities with NPI records 3

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

Organizations & group practices 10

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.

Hospital & facility affiliations 14

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

View all 14

NPI Registry JSON

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

{
    "created_epoch": "1369526400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1516320000000",
    "number": "1427495803",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1025 MAINE ST",
            "city": "QUINCY",
            "state": "IL",
            "postal_code": "623014038",
            "telephone_number": "217-222-6550",
            "fax_number": "217-277-2253"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1025 MAINE ST",
            "city": "QUINCY",
            "state": "IL",
            "postal_code": "623014038",
            "telephone_number": "217-222-6550",
            "fax_number": "217-277-2253"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ANDERSON",
        "first_name": "HALLEY",
        "middle_name": "C",
        "name_prefix": "Dr.",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-05-26",
        "last_updated": "2018-01-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "IL",
            "license": "036143810",
            "primary": false
        },
        {
            "code": "207QG0300X",
            "taxonomy_group": "",
            "desc": "Family Medicine, Geriatric Medicine",
            "state": "IL",
            "license": "036143810",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Quincy, IL

Sources for this page

Verify at the official NPI Registry.