Lydia D Anderson, DPT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

23611 Issued in MA

Practice address

3224 Orchard Ave
Edmond, OK 73012-9645

Phone

(719) 244-8147

Fax

(719) 244-8147

NPI assigned

Dec 8, 2017

Last updated

Jul 5, 2019By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in MA

Enrollment records 1

Specialty

Physical Therapist in Private Practice

Education

Other, 2017

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Bay State Physical Therapy of Randolph IncGroup PAC ID 6305744251, 451 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

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

• Bay State Physical Therapy of Randolph Inc

  dba Bay State Physical Therapy

  • Physical Therapist
  • Fall River, MA
  • NPI 1164474334
  Medicare reassignment Care Compare group

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

{
    "created_epoch": "1512691200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1562284800000",
    "number": "1609381979",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1180 BEACON ST",
            "address_2": "STE 6C",
            "city": "BROOKLINE",
            "state": "MA",
            "postal_code": "024463806",
            "telephone_number": "719-244-8147"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3224 ORCHARD AVE",
            "city": "EDMOND",
            "state": "OK",
            "postal_code": "730129645",
            "telephone_number": "719-244-8147",
            "fax_number": "719-244-8147"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ANDERSON",
        "first_name": "LYDIA",
        "middle_name": "D",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-12-08",
        "last_updated": "2019-07-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MA",
            "license": "23611",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Cheyenne Blu Anderson
• Cody M. Anderson, MD
• Katherine Nicole Anderson, LPC
• Lacey Snow Anderson, MS CCC SLP
• Lauren Anderson
• Matelean Anderson
• Micheal Anderson, LMFT-C
• Natassia Anderson, NTP
• Savanna Anderson
• Andrade Medical Services

• Physical Therapist in Edmond, OK
• Providers in Edmond, OK by specialty
• Physical Therapist in Oklahoma

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 5, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.