Organization Active NPI

Peter J Anderson, MD PC

  • Orthopaedic Surgery Physician
  • Fenton, MO
National Provider Identifier
1568433639
Registry record updated Aug 6, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopaedic Surgery PhysicianTaxonomy code 207X00000X
License
2004016388 Issued in MO
Legal business name
PETER J ANDERSON, MD PC
Practice address
1011 Bowles Ave
Suite 400
Fenton, MO 63026-2387
Phone
(314) 821-4884
Fax
(314) 821-4885
NPI assigned
Jan 27, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 6, 2009

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

Authorized official

Name
Peter J Anderson, MD
Title
Owner
Phone
(314) 768-3216

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Orthopaedic Surgery PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207X00000X 2004016388 MO Primary

Addresses

Primary practice location

1011 Bowles Ave
Suite 400
Fenton, MO 63026-2387

Mailing address

PO Box 1521
Minneapolis, MN 55480-1521
Phone (314) 989-0300

National Provider Directory

National Provider Directory

Locations

1055 Bowles Ave
Ste 100
Fenton, MO 63026
Phone (636) 203-9700

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1138320000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1249516800000",
    "number": "1568433639",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1521",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554801521",
            "telephone_number": "314-989-0300"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1011 BOWLES AVE",
            "address_2": "SUITE 400",
            "city": "FENTON",
            "state": "MO",
            "postal_code": "630262387",
            "telephone_number": "314-821-4884",
            "fax_number": "314-821-4885"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PETER J ANDERSON, MD PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-01-27",
        "last_updated": "2009-08-06",
        "status": "A",
        "authorized_official_last_name": "ANDERSON",
        "authorized_official_first_name": "PETER",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "314-768-3216",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207X00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Orthopaedic Surgery",
            "state": "MO",
            "license": "2004016388",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fenton, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 6, 2009; 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.