Clarissa A Anderson, RN

Primary specialty

General Practice Registered NurseTaxonomy code 163WG0000X

License

68115 Issued in NE

Practice address

4113 N 174TH Ave
Omaha, NE 68116-3093

Phone

(402) 871-4224

NPI assigned

Aug 2, 2021

Sex

Female

Sole proprietor

Yes

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

Medicare enrollment (NPD)

Not enrolled

Credentials

Registered Nurse

State licenses

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

{
    "created_epoch": "1627862400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1627862400000",
    "number": "1497429765",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4113 N 174TH AVE",
            "city": "OMAHA",
            "state": "NE",
            "postal_code": "681163093",
            "telephone_number": "402-871-4224"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4113 N 174TH AVE",
            "city": "OMAHA",
            "state": "NE",
            "postal_code": "681163093",
            "telephone_number": "402-871-4224"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ANDERSON",
        "first_name": "CLARISSA",
        "middle_name": "A",
        "credential": "RN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-08-02",
        "last_updated": "2021-08-02",
        "certification_date": "2021-08-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WG0000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, General Practice",
            "state": "NE",
            "license": "68115",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "totalwellness.com",
            "affiliation": "N",
            "endpointDescription": "website",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "website",
            "address_1": "4113 N 174th Ave",
            "city": "Omaha",
            "state": "NE",
            "country_code": "US",
            "postal_code": "681163093",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Brian Anderson
• Celeste Anderson
• Christi Anderson
• Christine M Anderson, CRNA
• Christopher W. Anderson, DO
• Colin Anderson
• Connie L Anderson, PA-C
• Corinne Anderson
• Courtney Anderson
• Courtney Anderson

• General Practice Registered Nurse in Omaha, NE
• Providers in Omaha, NE by specialty
• General Practice Registered Nurse in Nebraska

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 2, 2021; 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.