Devon Anderson

Individual provider Active NPI Anesthesiology Physician · Columbia, MO

NPI 1508619784 · NPPES record last updated Jul 1, 2025

Key facts

NPI
1508619784
Entity type
Individual (NPI type 1)
Primary specialty
Anesthesiology Physician 207L00000X
License
2025025209 (MO)
Practice address
1 Hospital Dr
Columbia, MO 65212-1000
Phone
(702) 853-3564
NPI assigned
Apr 8, 2024
Sex
Male
Sole proprietor
No

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Eligible to order & refer
Part B services: No · DME: Yes · Home health: No · Power mobility devices: Yes · Hospice: No

National Provider Directory

Medicare enrollment (NPD)
Yes

State licenses

LicenseStateTypeSpecialty
2025025209MOMDAnesthesiology Physician

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Anesthesiology Physician 207L00000X 2025025209 MO Yes

Addresses

Primary practice location

1 Hospital Dr
Columbia, MO 65212-1000

Mailing address

1 Hospital Dr
Columbia, MO 65212-1000

Other providers in Columbia, MO

All providers in Columbia, MO · Anesthesiology Physician in Missouri

Sources for this page

Verify at the official NPI Registry.