Individual provider Active NPI

Aaron Kevin Andersen, D.O.

  • Psychiatry Physician
  • Orem, UT
National Provider Identifier
1679821334
Registry record updated Jan 9, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
OP61111296 Issued in WA
Practice address
835 E 1200 S
Orem, UT 84097-6603
Phone
(307) 267-6170
Fax
(801) 877-0002
NPI assigned
Aug 28, 2012
Last updated
Jan 9, 2026By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 9, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X OP61111296 WA Primary

Addresses

Primary practice location

835 E 1200 S
Orem, UT 84097-6603

Mailing address

PO Box 50095
Seattle, WA 98145-5095

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TN, WA2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20200121001823 TN Practitioner - Psychiatry 6901020338 Reassigns benefits to 1 organization
I20201109002610 WA Practitioner - Psychiatry 6901020338 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

Practice roles

OrganizationSpecialtyStatusNew patients
BHC Fairfax Hospital Inc. Psychiatry CurrentSince Mar 13, 2023 Accepting new patients
Blue Ridge Medical Management Corporation Current Accepting new patients
Blue Ridge Medical Management Corporation Psychiatry CurrentSince Dec 1, 2019 Accepting new patients
Blue Ridge Medical Management Corporation CurrentSince Dec 1, 2019 Accepting new patients

Locations

1497 W Elk Ave
Ste 20
Elizabethton, TN 37643
Phone (423) 547-7380

1019 W Oakland Ave
Ste 1
Johnson City, TN 37604
Phone (423) 915-5000

403 N State of Franklin Rd
Johnson City, TN 37604
Phone (423) 431-7042

10200 NE 132nd St
Kirkland, WA 98034
Phone (425) 821-2000

Organizations & group practices 4

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": "1346112000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1767916800000",
    "number": "1679821334",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 50095",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981455095"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "835 E 1200 S",
            "city": "OREM",
            "state": "UT",
            "postal_code": "840976603",
            "telephone_number": "307-267-6170",
            "fax_number": "801-877-0002"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ANDERSEN",
        "first_name": "AARON",
        "middle_name": "KEVIN",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-08-28",
        "last_updated": "2026-01-09",
        "certification_date": "2026-01-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "WA",
            "license": "OP61111296",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Orem, UT

Sources for this page

Verify at the official NPI Registry.