Arne John Anderson, MD

Primary specialty

Developmental - Behavioral Pediatrics PhysicianTaxonomy code 2080P0006X

License

2019-02862 Issued in NC

Practice address

3325 Silas Creek Pkwy
Winston Salem, NC 27103-3013

Phone

(336) 713-7429

Fax

(336) 713-7842

NPI assigned

Aug 12, 2005

Sex

Male

Sole proprietor

No

Medicare fee-for-service enrollment

Enrolled in NC

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.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Interoperability endpoints

• Direct secure messaging: aanderson2754497@carolinashealthcaresystem.direct-ci.com

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Apr 5, 2022.

{
    "created_epoch": "1123804800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1649116800000",
    "number": "1528060209",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 KIMEL FOREST DR",
            "city": "WINSTON SALEM",
            "state": "NC",
            "postal_code": "271036074",
            "telephone_number": "336-716-0238"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3325 SILAS CREEK PKWY",
            "city": "WINSTON SALEM",
            "state": "NC",
            "postal_code": "271033013",
            "telephone_number": "336-713-7429",
            "fax_number": "336-713-7842"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "108 W Fire Tower Rd",
            "address_purpose": "LOCATION",
            "city": "Winterville",
            "state": "NC",
            "postal_code": "285908371",
            "country_code": "US",
            "telephone_number": "252-328-3221",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ANDERSON",
        "first_name": "ARNE",
        "middle_name": "JOHN",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-08-12",
        "last_updated": "2022-04-05",
        "certification_date": "2022-04-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2080P0006X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Developmental - Behavioral Pediatrics",
            "state": "MD",
            "license": "D0041412",
            "primary": false
        },
        {
            "code": "2080P0006X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Developmental - Behavioral Pediatrics",
            "state": "NC",
            "license": "2019-02862",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Destiny Anders
• Onitisha V Anders, NP
• Courtney Rohan Andersen, P.A.-C
• Mousumi Medda Andersen, M.D.
• William Donald Andersen, M.D.
• August Anderson, MD
• Brett Matthew Anderson, PA-C
• Brynlee Parker Anderson, PA
• Catherine Anderson
• Chloe Grace Anderson, LMBT

• All providers in Winston Salem, NC
• Developmental - Behavioral Pediatrics Physician in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 5, 2022; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.