Individual provider Active NPI

Alicia Anderson, APRN

  • Family Nurse Practitioner
  • Mt Washington, KY
National Provider Identifier
1639748569
Registry record updated Feb 17, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
3016296 Issued in KY
Practice address
138 Eastbrooke CT Unit 115
Mount Washington, KY 40047-5570
Phone
(502) 617-4068
NPI assigned
Jun 24, 2021
Last updated
Feb 17, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 17, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 3016296 KY Primary

Addresses

Primary practice location

138 Eastbrooke CT Unit 115
Mount Washington, KY 40047-5570

Mailing address

138 Eastbrooke CT Unit 115
Mount Washington, KY 40047-5570
Phone (502) 617-4068

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
3016296KYMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Mt Washington Pediatrics PLLC Family CurrentSince Feb 23, 2025 Accepting new patients

Locations

138 Eastbrooke Ct
Unit 115
Mt Washington, KY 40047
Phone (502) 617-4068

Interoperability endpoints

  • Direct secure messaging: alicia.anderson.1@30410.direct.athenahealth.com
  • FHIR API: https://fhir4.healow.com/fhir/r4/EEABED/Endpoint/EEABED

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.

NPI Registry JSON

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

{
    "created_epoch": "1624492800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1739750400000",
    "number": "1639748569",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "138 EASTBROOKE CT UNIT 115",
            "city": "MOUNT WASHINGTON",
            "state": "KY",
            "postal_code": "400475570",
            "telephone_number": "502-617-4068"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "138 EASTBROOKE CT UNIT 115",
            "city": "MOUNT WASHINGTON",
            "state": "KY",
            "postal_code": "400475570",
            "telephone_number": "502-617-4068"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ANDERSON",
        "first_name": "ALICIA",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-06-24",
        "last_updated": "2025-02-17",
        "certification_date": "2025-02-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "KY",
            "license": "3016296",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mt Washington, KY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 17, 2025; 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.