David Conrad Anderson, M.D.

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

D0043236 Issued in MD

Practice address

2401 Brandermill Blvd
Suite 360
Gambrills, MD 21054-1690

Phone

(410) 721-9862

Fax

(410) 721-9865

NPI assigned

Jul 22, 2005

Last updated

Sep 23, 2008By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 11

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Opted out of Medicare

Yes, effective Dec 19, 2013 through Dec 19, 2027

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Medicine

State licenses

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

{
    "created_epoch": "1121990400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1222128000000",
    "number": "1508866336",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2401 BRANDERMILL BLVD",
            "address_2": "SUITE 360",
            "city": "GAMBRILLS",
            "state": "MD",
            "postal_code": "210541690",
            "telephone_number": "410-721-9862",
            "fax_number": "410-721-9865"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2401 BRANDERMILL BLVD",
            "address_2": "SUITE 360",
            "city": "GAMBRILLS",
            "state": "MD",
            "postal_code": "210541690",
            "telephone_number": "410-721-9862",
            "fax_number": "410-721-9865"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ANDERSON",
        "first_name": "DAVID",
        "middle_name": "CONRAD",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-07-22",
        "last_updated": "2008-09-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MD",
            "license": "D0043236",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "JHHC PROVIDER NUMBER",
            "identifier": "037532",
            "state": "MD"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA FEE FOR SERVICE",
            "identifier": "4334366",
            "state": "MD"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CAREFIRST MPOS",
            "identifier": "P13160",
            "state": "MD"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA CAPITATED",
            "identifier": "0521276",
            "state": "MD"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "80151940",
            "state": "MD"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CAREFIRST MD RENDERING",
            "identifier": "525954-02",
            "state": "MD"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CAREFIRST BLUECHOICE",
            "identifier": "7605-0002",
            "state": "MD"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "192191600",
            "state": "MD"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MAMSI SPECIALIST",
            "identifier": "242087",
            "state": "MD"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MAMSI PRIMARY CARE",
            "identifier": "842087",
            "state": "MH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CIGNA PIN",
            "identifier": "0826714",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Beatrice Aina
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• Madea Ebony Allen, LAC
• Alliance Healthcare and Staffing Solutions Inc (Alliance Healthcare)
• Amanda Lyn Amoroso, LMT
• Korin Andreas, LCSW-C
• Angel Management, Inc Dba Brightstar Healthcare
• Anne Arundel Primary Care
• Arundel Neurology, P.a.
• Ati Holdings, LLC

• Family Medicine Physician in Gambrills, MD
• Providers in Gambrills, MD by specialty
• Family Medicine Physician in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 23, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.