Active NPI
Cameron D Anderson, M.D.
- Obstetrics & Gynecology Physician
- Payson, UT
National Provider Identifier
1629096870
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Obstetrics & Gynecology Physician
- License
- 361821-1205
- Practice address
- 39 Professional Way
Suite 4
Payson, UT 84651-1675 - Phone
- (801) 465-3201
- Fax
- (801) 465-2889
- NPI assigned
- Jul 17, 2006
- Last updated
- Aug 20, 2013
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Obstetrics & Gynecology Physician | 207V00000X | 361821-1205 | UT | Primary |
Addresses
Primary practice location
39 Professional Way
Suite 4
Payson, UT 84651-1675
Mailing address
39 Professional Way
Suite 4
Payson, UT 84651-1675
Phone (801) 465-3201
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| D2677 | Medicaid | UT |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in UT
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 361821-1205 | UT | MD | Obstetrics & Gynecology Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Valley Obstetrics and Gynecology, PC | Obstetrics & Gynecology | Current | Accepting new patients |
Locations
585 N 500 W
Provo, UT 84601
Phone (801) 374-1801
Organizations & group practices 1
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.
-
- Obstetrics & Gynecology Physician
- American Fork, UT
- NPI 1588863377
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1153094400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1376956800000",
"number": "1629096870",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "39 PROFESSIONAL WAY",
"address_2": "SUITE 4",
"city": "PAYSON",
"state": "UT",
"postal_code": "846511675",
"telephone_number": "801-465-3201",
"fax_number": "801-465-2889"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "39 PROFESSIONAL WAY",
"address_2": "SUITE 4",
"city": "PAYSON",
"state": "UT",
"postal_code": "846511675",
"telephone_number": "801-465-3201",
"fax_number": "801-465-2889"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ANDERSON",
"first_name": "CAMERON",
"middle_name": "D",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-07-17",
"last_updated": "2013-08-20",
"status": "A"
},
"taxonomies": [
{
"code": "207V00000X",
"taxonomy_group": "",
"desc": "Obstetrics & Gynecology",
"state": "UT",
"license": "361821-1205",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "D2677",
"state": "UT"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Payson, UT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 20, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.