Kurt B Anderson, PA-C

Primary specialty

Medical Physician AssistantTaxonomy code 363AM0700X

License

5601001492 Issued in MI

Practice address

3280 Woods Way Ste 1
Petoskey, MI 49770-8105

Phone

(231) 348-3800

Fax

(877) 529-6854

NPI assigned

Sep 25, 2006

Last updated

Mar 31, 2011By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

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.

• McLaren Northern Michigan

  • Family Medicine Physician
  • Petoskey, MI
  • NPI 1760736094
  NPD (past)

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

{
    "created_epoch": "1159142400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1301529600000",
    "number": "1447350855",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3280 WOODS WAY STE 1",
            "city": "PETOSKEY",
            "state": "MI",
            "postal_code": "497708105",
            "telephone_number": "231-348-3800",
            "fax_number": "877-529-6854"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3280 WOODS WAY STE 1",
            "city": "PETOSKEY",
            "state": "MI",
            "postal_code": "497708105",
            "telephone_number": "231-348-3800",
            "fax_number": "877-529-6854"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ANDERSON",
        "first_name": "KURT",
        "middle_name": "B",
        "name_prefix": "Mr.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-25",
        "last_updated": "2011-03-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "MI",
            "license": "5601001492",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jane Stieber Amato, DDS, MSD, MPH
• Amelia Fettig Counseling
• Amy L. Juneau, LMSW, Osw-C, LLC
• Adam Ancel, MS ATC PA-S
• Joshua Thomas Anderson, MD
• Roy Lee Angel Jr.
• Deanna Angers, DO
• Joseph Angileri
• Michael A Angileri, MD
• Frank Animikwam, MD

• Medical Physician Assistant in Petoskey, MI
• Providers in Petoskey, MI by specialty
• Medical Physician Assistant in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 31, 2011; 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.