Individual provider Active NPI

David W Anderson

  • Nursing Facility/Intermediate Care Facility
  • Waterbury, VT
National Provider Identifier
1497173470
Registry record updated Apr 7, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nursing Facility/Intermediate Care FacilityTaxonomy code 313M00000X
License
0154 Issued in VT
Practice address
26 Union St
Waterbury, VT 05676-1303
Phone
(802) 244-6403
Fax
(802) 244-1486
NPI assigned
Apr 7, 2014
Last updated
Apr 7, 2014By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 7, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nursing Facility/Intermediate Care Facility 313M00000X 0154 VT Primary

Addresses

Primary practice location

26 Union St
Waterbury, VT 05676-1303

Mailing address

26 Union St
Waterbury, VT 05676-1303
Phone (802) 244-6403

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)
Not enrolled

State licenses

LicenseStateTypeSpecialty
0154VTMDNursing Facility/Intermediate Care Facility

Practice roles

OrganizationSpecialtyStatusNew patients
The Squier House, Inc. Past Accepting new patients
Maple Hill Residential Care Home Nursing Facility/Intermediate Care Facility Past Accepting new patients

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1396828800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1396828800000",
    "number": "1497173470",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "26 UNION ST",
            "city": "WATERBURY",
            "state": "VT",
            "postal_code": "056761303",
            "telephone_number": "802-244-6403",
            "fax_number": "802-244-1486"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "26 UNION ST",
            "city": "WATERBURY",
            "state": "VT",
            "postal_code": "056761303",
            "telephone_number": "802-244-6403",
            "fax_number": "802-244-1486"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ANDERSON",
        "first_name": "DAVID",
        "middle_name": "W",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2014-04-07",
        "last_updated": "2014-04-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "313M00000X",
            "taxonomy_group": "",
            "desc": "Nursing Facility/Intermediate Care Facility",
            "state": "VT",
            "license": "0154",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Waterbury, VT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 7, 2014; 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.