Individual provider Active NPI

Kathleen B Anderson, MD

  • Family Medicine Physician
  • Calabasas, CA
National Provider Identifier
1629029996
Registry record updated Sep 13, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
G35393 Issued in CA
Practice address
23501 Park Sorrento
Suite 210
Calabasas, CA 91302-1308
Phone
(818) 222-7871
Fax
(818) 222-7894
NPI assigned
May 12, 2006
Last updated
Sep 13, 2010By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 13, 2010

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X G58593 CA
Family Medicine Physician 207Q00000X G35393 CA Primary

Addresses

Primary practice location

23501 Park Sorrento
Suite 210
Calabasas, CA 91302-1308

Mailing address

23501 Park Sorrento
Suite 210
Calabasas, CA 91302-1308
Phone (818) 222-7871

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
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

Enrollment IDStateProvider typePAC IDDetails
I20070119000299 CA Practitioner - Family PracticePractitioner - General Practice 5193726008

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
58593CAMDDentist
G35393CAMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Los Robles Regional Medical Center Past Accepting new patients
Focus Center for Sleep Apnea and Snoring, LLC Past Accepting new patients
Action Urgent Care Inc PastSince Nov 21, 2017 Accepting new patients

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/24970/brand/1/csg/1/fhir/r4

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1147392000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1284336000000",
    "number": "1629029996",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "23501 PARK SORRENTO",
            "address_2": "SUITE 210",
            "city": "CALABASAS",
            "state": "CA",
            "postal_code": "913021308",
            "telephone_number": "818-222-7871",
            "fax_number": "818-222-7894"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "23501 PARK SORRENTO",
            "address_2": "SUITE 210",
            "city": "CALABASAS",
            "state": "CA",
            "postal_code": "913021308",
            "telephone_number": "818-222-7871",
            "fax_number": "818-222-7894"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ANDERSON",
        "first_name": "KATHLEEN",
        "middle_name": "B",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-05-12",
        "last_updated": "2010-09-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "G58593",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "G35393",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Calabasas, CA

Sources for this page

Verify at the official NPI Registry.