Individual provider Active NPI

Cara Elizabeth Anderson, FNP-BC

  • Family Nurse Practitioner
  • Cathedral City, CA
National Provider Identifier
1629541677
Registry record updated Jul 30, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
95033817 Issued in CA
Practice address
69175 Ramon Rd
Cathedral City, CA 92234-3344
Phone
(760) 321-6776
NPI assigned
Jan 2, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 30, 2025

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X RN235670 GA
Family Nurse Practitioner 363LF0000X RN235670 GA
Family Nurse Practitioner 363LF0000X 95033817 CA Primary

Addresses

Primary practice location

69175 Ramon Rd
Cathedral City, CA 92234-3344

Mailing address

101 Harris Industrial Blvd Ste C
Vidalia, GA 30474-8852
Phone (912) 537-1014

Other practice location 1

1707 Meadows Ln Ste A
Vidalia, GA 30474-7201
Phone (912) 537-1014

Other practice location 2

107 Canal St
Pooler, GA 31322-4016
Phone (912) 450-1945

Other practice location 3

101 Harris Industrial Blvd Ste C
Vidalia, GA 30474-8852
Phone (912) 537-1014

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA
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 1

Enrollment IDStateProvider typePAC IDDetails
I20190225003001 GA Practitioner - Nurse Practitioner 0446599104

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
95033817CAMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
St Josephs Candler Urgent Care Centers LLC CurrentSince Sep 21, 2023 Accepting new patients
St Josephs Candler Urgent Care Centers LLC CurrentSince Sep 21, 2023 Accepting new patients
Southeast Regional Primary Care Corporation Current Accepting new patients

Locations

107 Canal St
Pooler, GA 31322
Phone (912) 450-1945

101 Saint Josephs Candler Dr
Ste 100
Pooler, GA 31322
Phone (912) 450-1945

361 Commercial Dr
Savannah, GA 31406
Phone (912) 355-6221

Interoperability endpoints

  • Direct secure messaging: cara.anderson@srpcc.gadirect.net

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1546387200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1753833600000",
    "number": "1629541677",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "101 HARRIS INDUSTRIAL BLVD STE C",
            "city": "VIDALIA",
            "state": "GA",
            "postal_code": "304748852",
            "telephone_number": "912-537-1014",
            "fax_number": "912-538-0979"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "69175 RAMON RD",
            "city": "CATHEDRAL CITY",
            "state": "CA",
            "postal_code": "922343344",
            "telephone_number": "760-321-6776"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1707 Meadows Ln Ste A",
            "address_purpose": "LOCATION",
            "city": "Vidalia",
            "state": "GA",
            "postal_code": "304747201",
            "country_code": "US",
            "telephone_number": "912-537-1014",
            "fax_number": "912-538-0979",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "107 Canal St",
            "address_purpose": "LOCATION",
            "city": "Pooler",
            "state": "GA",
            "postal_code": "313224016",
            "country_code": "US",
            "telephone_number": "912-450-1945",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "101 Harris Industrial Blvd Ste C",
            "address_purpose": "LOCATION",
            "city": "Vidalia",
            "state": "GA",
            "postal_code": "304748852",
            "country_code": "US",
            "telephone_number": "912-537-1014",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ANDERSON",
        "first_name": "CARA",
        "middle_name": "ELIZABETH",
        "credential": "FNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-01-02",
        "last_updated": "2025-07-30",
        "certification_date": "2025-07-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "GA",
            "license": "RN235670",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "GA",
            "license": "RN235670",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CA",
            "license": "95033817",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cathedral City, CA

Sources for this page

Verify at the official NPI Registry.