Active NPI
Steven Eric Anderson, P.A.
- Physician Assistant
- North Wilkesboro, NC
National Provider Identifier
1467451203
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- 100443
- Practice address
- 1917 W Park Dr
North Wilkesboro, NC 28659-3585 - Phone
- (336) 903-7845
- Fax
- (336) 903-7841
- NPI assigned
- Jul 14, 2005
- Last updated
- Nov 27, 2012
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 5
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | PA3125 | FL | |
| Physician Assistant | 363A00000X | 100443 | NC | Primary |
| Medical Physician Assistant | 363AM0700X | PA3125 | FL | |
| Medical Physician Assistant | 363AM0700X | 100443 | NC | |
| Surgical Physician Assistant | 363AS0400X | PA3125 | FL |
Addresses
Primary practice location
1917 W Park Dr
North Wilkesboro, NC 28659-3585
Mailing address
4601 Park Rd
Suite 300
Charlotte, NC 28209-3239
Phone (704) 323-2000
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| NC9073A | Other | NC | MEDICARE PTAN, INDIVIDUAL AT WILKES |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 100443 | NC | MD | Medical Physician Assistant |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Jewett Orthopaedic Clinic LLC | Past | Accepting new patients |
Organizations & group practices 1
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.
-
- Orthopaedic Surgery Physician
- Winter Park, FL
- NPI 1821097437
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1121299200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1353974400000",
"number": "1467451203",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4601 PARK RD",
"address_2": "SUITE 300",
"city": "CHARLOTTE",
"state": "NC",
"postal_code": "282093239",
"telephone_number": "704-323-2000"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1917 W PARK DR",
"city": "NORTH WILKESBORO",
"state": "NC",
"postal_code": "286593585",
"telephone_number": "336-903-7845",
"fax_number": "336-903-7841"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ANDERSON",
"first_name": "STEVEN",
"middle_name": "ERIC",
"name_prefix": "Mr.",
"credential": "P.A.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2005-07-14",
"last_updated": "2012-11-27",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "FL",
"license": "PA3125",
"primary": false
},
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "NC",
"license": "100443",
"primary": true
},
{
"code": "363AM0700X",
"taxonomy_group": "",
"desc": "Physician Assistant, Medical",
"state": "FL",
"license": "PA3125",
"primary": false
},
{
"code": "363AM0700X",
"taxonomy_group": "",
"desc": "Physician Assistant, Medical",
"state": "NC",
"license": "100443",
"primary": false
},
{
"code": "363AS0400X",
"taxonomy_group": "",
"desc": "Physician Assistant, Surgical",
"state": "FL",
"license": "PA3125",
"primary": false
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDICARE PTAN, INDIVIDUAL AT WILKES",
"identifier": "NC9073A",
"state": "NC"
}
],
"endpoints": [],
"other_names": []
}
Other providers in North Wilkesboro, NC
- Abigail Watkins Anderson, PT, DPT
- Ashley Christine Anderson, DPT
- Cristina Anderson, FNP-BC
- Elizabeth Faw Anderson, DPT
- Michael Joseph Anderson II
- Steven R. Anderson, MD
- Chris Anthony
- Artizo Ministries
- Derwood Lee Ashworth, D.D.S., M.SC.O.
- Ats of North Carolina, LLC (Mountain Health Solutions North Wilkesboro)
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 27, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.