Individual provider Active NPI

Morgan Anderson, PA-C

  • Physician Assistant
  • San Luis Obispo, CA
National Provider Identifier
1578023040
Registry record updated Feb 6, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
8031 Issued in AZ
Practice address
77 Casa St
San Luis Obispo, CA 93405-5803
Phone
(805) 269-1500
Fax
(805) 269-1585
NPI assigned
Mar 21, 2019
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 6, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Clinical Nurse Specialist 364SP0808X 8031 AZ
Physician AssistantGroup: 193400000X SINGLE SPECIALTY GROUP 363A00000X 8031 AZ Primary

Addresses

Primary practice location

77 Casa St
San Luis Obispo, CA 93405-5803

Mailing address

2050 S Blosser Rd
Santa Maria, CA 93458-7310
Phone (805) 361-8030

Other practice location 1

3033 N Central Ave Ste 700
Phoenix, AZ 85012-2806
Phone (602) 230-7373

Other practice location 2

9494 W Northern Ave Ste 101
Glendale, AZ 85305-1119
Phone (623) 872-6156

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AZ, CA2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20201102002078 AZ Practitioner - Physician Assistant 1456761410 Reassigns benefits to 3 organizations
I20250212002829 CA Practitioner - Physician Assistant 1456761410 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
8031AZMDChiropractor
65026CAMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Community Health Centers of the Central Coast Inc Single Specialty Current Accepting new patients
Community Health Centers of the Central Coast Inc CurrentSince Jan 20, 2025 Accepting new patients
Denova Collaborative Health, LLC CurrentSince Feb 1, 2023 Accepting new patients
Community Health Centers of the Central Coast, Inc CurrentSince Jan 20, 2025 Accepting new patients
Denova Collaborative Health, LLC CurrentSince Feb 1, 2023 Accepting new patients
Community Health Centers of the Central Coast Inc Single Specialty Current Accepting new patients

Locations

2204 S Dobson Rd
Ste 102
Mesa, AZ 85202

3101 N Central Ave
Ste 500
Phoenix, AZ 85012

77 E Columbus Ave
Ste 210
Phoenix, AZ 85012

3033 N Central Ave
Ste 700
Phoenix, AZ 85012
Phone (602) 281-7289

150 Tejas Pl
Nipomo, CA 93444
Phone (805) 929-3254

2050 S Blosser Rd
Santa Maria, CA 93458
Phone (805) 361-8014

77 Casa St
Sn Luis Obisp, CA 93405
Phone (805) 269-1500

1551 Bishop St
Ste A160
Sn Luis Obisp, CA 93401
Phone (805) 781-4230

Interoperability endpoints

  • Direct secure messaging: morgan.anderson.1@17363.direct.athenahealth.com

Organizations & group practices 10

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1553126400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1738800000000",
    "number": "1578023040",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2050 S BLOSSER RD",
            "city": "SANTA MARIA",
            "state": "CA",
            "postal_code": "934587310",
            "telephone_number": "805-361-8030",
            "fax_number": "805-361-8097"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "77 CASA ST",
            "city": "SAN LUIS OBISPO",
            "state": "CA",
            "postal_code": "934055803",
            "telephone_number": "805-269-1500",
            "fax_number": "805-269-1585"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3033 N Central Ave Ste 700",
            "address_purpose": "LOCATION",
            "city": "Phoenix",
            "state": "AZ",
            "postal_code": "850122806",
            "country_code": "US",
            "telephone_number": "602-230-7373",
            "fax_number": "602-257-8029",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "9494 W Northern Ave Ste 101",
            "address_purpose": "LOCATION",
            "city": "Glendale",
            "state": "AZ",
            "postal_code": "853051119",
            "country_code": "US",
            "telephone_number": "623-872-6156",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ANDERSON",
        "first_name": "MORGAN",
        "credential": "PA-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-03-21",
        "last_updated": "2025-02-06",
        "certification_date": "2025-02-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "364SP0808X",
            "taxonomy_group": "",
            "desc": "Clinical Nurse Specialist, Psychiatric/Mental Health",
            "state": "AZ",
            "license": "8031",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physician Assistant",
            "state": "AZ",
            "license": "8031",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Luis Obispo, CA

Sources for this page

Verify at the official NPI Registry.