Greg Anderson MD LLC

Primary specialty

Preferred Provider OrganizationTaxonomy code 305R00000X

Legal business name

GREG ANDERSON MD LLC

Practice address

1520 9TH St
Suite 230
Highland, IL 62249-1677

Phone

(618) 654-3400

Fax

(618) 654-3442

NPI assigned

Jan 30, 2007

Organization subpart

No

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

Authorized official

Name

Mr. Gregory Anderson, MD

Title

Owner

Phone

(618) 654-3400

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1170115200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1202774400000",
    "number": "1619013265",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1520 9TH ST",
            "address_2": "SUITE 230",
            "city": "HIGHLAND",
            "state": "IL",
            "postal_code": "622491677",
            "telephone_number": "618-654-3400",
            "fax_number": "618-654-3442"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1520 9TH ST",
            "address_2": "SUITE 230",
            "city": "HIGHLAND",
            "state": "IL",
            "postal_code": "622491677",
            "telephone_number": "618-654-3400",
            "fax_number": "618-654-3442"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GREG ANDERSON MD LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-30",
        "last_updated": "2008-02-12",
        "status": "A",
        "authorized_official_last_name": "ANDERSON",
        "authorized_official_first_name": "GREGORY",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "618-654-3400",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "305R00000X",
            "taxonomy_group": "",
            "desc": "Preferred Provider Organization",
            "state": "IL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Itzel Gomez
• Christina Gonzales
• Lisset Gonzalez
• Amber Gore
• Hannah K Greeling
• Megan Griesbaum
• Shandra Griffin
• Jordan Groennert, DPT
• Pamella S Gronemeyer, M.D.
• Bret W Gruender, D.M.D.

• Preferred Provider Organization in Highland, IL
• Providers in Highland, IL by specialty
• Preferred Provider Organization in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 12, 2008; 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.