Individual provider Active NPI

Fallan L Pryor Anderson, NP

  • Family Nurse Practitioner
  • Jbphh, HI
National Provider Identifier
1689030959
Registry record updated Aug 22, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
0992131 Issued in CO
Practice address
755 Scott Cir
Jbphh, HI 96853-5399
Phone
(808) 448-6100
NPI assigned
Jan 2, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2025

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 833052 NV
Family Nurse Practitioner 363LF0000X 18858 OH
Family Nurse Practitioner 363LF0000X R240367 MD
Family Nurse Practitioner 363LF0000X 0992131 CO Primary

Addresses

Primary practice location

755 Scott Cir
Jbphh, HI 96853-5399

Mailing address

755 Scott Cir
Jbphh, HI 96853-5399
Phone (808) 448-6100

Other names 1

  • Fallan Pryor Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH
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
I20170623001529 OH Practitioner - Nurse Practitioner 6709154214 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
18858OHMDGeneral Practice Dentistry
0992131COMDFamily Nurse Practitioner
833052NVMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Vpa PC Current Accepting new patients
Vpa PC CurrentSince Jun 1, 2017 Accepting new patients
Vpa PC Current Accepting new patients
Vpa PC CurrentSince Jun 1, 2017 Accepting new patients

Locations

500 Kirts Blvd
Ste 100
Troy, MI 48084
Phone (214) 824-6000

355 E Campus View Blvd
Ste 180
Columbus, OH 43235
Phone (614) 523-2155

3033 Kettering Blvd
Ste 100
Moraine, OH 45439
Phone (937) 293-2133

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1451692800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1755820800000",
    "number": "1689030959",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "755 SCOTT CIR",
            "city": "JBPHH",
            "state": "HI",
            "postal_code": "968535399",
            "telephone_number": "808-448-6100"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "755 SCOTT CIR",
            "city": "JBPHH",
            "state": "HI",
            "postal_code": "968535399",
            "telephone_number": "808-448-6100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PRYOR ANDERSON",
        "first_name": "FALLAN",
        "middle_name": "L",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-01-02",
        "last_updated": "2025-08-22",
        "certification_date": "2025-08-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NV",
            "license": "833052",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "OH",
            "license": "18858",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MD",
            "license": "R240367",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CO",
            "license": "0992131",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "FALLAN",
            "last_name": "PRYOR",
            "credential": "FNP, MSN, DNP",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Jbphh, HI

Sources for this page

Verify at the official NPI Registry.