Individual provider Active NPI

Anneliese Zandan, FNP-C

  • Family Nurse Practitioner
  • Austin, TX
National Provider Identifier
1679104517
Registry record updated Jan 29, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
870450 Issued in TX
Practice address
11207 N Lamar Blvd
Austin, TX 78753-3056
Phone
(512) 906-0168
NPI assigned
Jan 29, 2020
Last updated
Jan 29, 2020By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 29, 2020

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 870450 TX Primary

Addresses

Primary practice location

11207 N Lamar Blvd
Austin, TX 78753-3056

Mailing address

11207 N Lamar Blvd
Austin, TX 78753-3056

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
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
870450TXMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Yun W Kim, MD, PA CurrentSince Apr 26, 2023 Accepting new patients
VMD Primary Providers of South Central Texas PLLC CurrentSince Aug 1, 2022 Accepting new patients

Locations

11207 N Lamar Blvd
Austin, TX 78753
Phone (512) 906-0168

11207 N Lamar Blvd
Ste B
Austin, TX 78753
Phone (512) 649-2195

Organizations & group practices 2

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": "1580256000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1580256000000",
    "number": "1679104517",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11207 N LAMAR BLVD",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787533056"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11207 N LAMAR BLVD",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787533056",
            "telephone_number": "512-906-0168"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ZANDAN",
        "first_name": "ANNELIESE",
        "credential": "FNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-01-29",
        "last_updated": "2020-01-29",
        "certification_date": "2020-01-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TX",
            "license": "870450",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Austin, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 29, 2020; 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.