Individual provider Active NPI

Anna A. Anderson, LPN

  • Licensed Practical Nurse
  • Tacoma, WA
National Provider Identifier
1508237033
Registry record updated Oct 9, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Licensed Practical NurseTaxonomy code 164W00000X
License
60452410 Issued in WA
Practice address
9040 Reid Street, Attn: MCHJ-CLQ-C
Madigan Army Medical Center
Tacoma, WA 98431-1000
Phone
(253) 968-1110
Fax
(877) 874-1031
NPI assigned
Oct 9, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 9, 2015

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Licensed Practical Nurse 164W00000X 0064972 OK
Licensed Practical Nurse 164W00000X 201404047 OR
Licensed Practical Nurse 164W00000X 60452410 WA Primary

Addresses

Primary practice location

9040 Reid Street, Attn: MCHJ-CLQ-C
Madigan Army Medical Center
Tacoma, WA 98431-1000

Mailing address

9040 Reid Street, Attn: MCHJ-CLQ-C
Madigan Army Medical Center
Tacoma, WA 98431-1000
Phone (253) 968-1110

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
0064972OKMDLicensed Practical Nurse
201404047ORMDLicensed Practical Nurse
60452410WAMDLicensed Practical Nurse

NPI Registry JSON

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

{
    "created_epoch": "1444348800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1444348800000",
    "number": "1508237033",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9040 REID STREET, ATTN: MCHJ-CLQ-C",
            "address_2": "MADIGAN ARMY MEDICAL CENTER",
            "city": "TACOMA",
            "state": "WA",
            "postal_code": "984311000",
            "telephone_number": "253-968-1110",
            "fax_number": "877-874-1031"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9040 REID STREET, ATTN: MCHJ-CLQ-C",
            "address_2": "MADIGAN ARMY MEDICAL CENTER",
            "city": "TACOMA",
            "state": "WA",
            "postal_code": "984311000",
            "telephone_number": "253-968-1110",
            "fax_number": "877-874-1031"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ANDERSON",
        "first_name": "ANNA",
        "middle_name": "A.",
        "name_prefix": "Ms.",
        "credential": "LPN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-10-09",
        "last_updated": "2015-10-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "OK",
            "license": "0064972",
            "primary": false
        },
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "OR",
            "license": "201404047",
            "primary": false
        },
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "WA",
            "license": "60452410",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tacoma, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 9, 2015; 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.