Active NPI
Michael William Anderson, MD
- Emergency Medicine Physician
- Ridgway, CO
National Provider Identifier
1659346377
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Emergency Medicine Physician
- License
- 37032
- Practice address
- 642 Marmot Dr
Ridgway, CO 81432-9484 - Phone
- (303) 619-3787
- NPI assigned
- Feb 17, 2006
- 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 |
|---|---|---|---|---|
| Emergency Medicine Physician | 207P00000X | 37032 | CO | Primary |
Addresses
Primary practice location
642 Marmot Dr
Ridgway, CO 81432-9484
Mailing address
642 Marmot Dr
Ridgway, CO 81432-9484
Phone (303) 619-3787
Other practice location 1
7700 S Broadway
Littleton, CO 80122-2602
Phone (303) 730-5800
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 930071972 | Other | CO | RR MEDICARE |
| 56373384 | Medicaid | CO |
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| CONNECT URL | Ridgway |
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)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 37032 | CO | MD | Emergency Medicine Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1140134400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1645574400000",
"number": "1659346377",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "642 MARMOT DR",
"city": "RIDGWAY",
"state": "CO",
"postal_code": "814329484",
"telephone_number": "303-619-3787"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "642 MARMOT DR",
"city": "RIDGWAY",
"state": "CO",
"postal_code": "814329484",
"telephone_number": "303-619-3787"
}
],
"practiceLocations": [
{
"address_1": "7700 S Broadway",
"address_purpose": "LOCATION",
"city": "Littleton",
"state": "CO",
"postal_code": "801222602",
"country_code": "US",
"telephone_number": "303-730-5800",
"fax_number": "303-730-5868",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "ANDERSON",
"first_name": "MICHAEL",
"middle_name": "WILLIAM",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-02-17",
"last_updated": "2022-02-23",
"certification_date": "2022-02-04",
"status": "A"
},
"taxonomies": [
{
"code": "207P00000X",
"taxonomy_group": "",
"desc": "Emergency Medicine",
"state": "CO",
"license": "37032",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "RR MEDICARE",
"identifier": "930071972",
"state": "CO"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "56373384",
"state": "CO"
}
],
"endpoints": [
{
"endpointType": "CONNECT",
"endpointTypeDescription": "CONNECT URL",
"endpoint": "Ridgway",
"affiliation": "N",
"address_1": "642 Marmot Dr",
"city": "Ridgway",
"state": "CO",
"country_code": "US",
"postal_code": "814329484",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}Other providers in Ridgway, CO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 23, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.