Active NPI
Lisa D Anderson, M.D.
- Emergency Medical Services (Emergency Medicine) Physician
- Madison, MS
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Emergency Medical Services (Emergency Medicine) Physician
- License
- 16045
- Practice address
- 935 Highway 51
Madison, MS 39110-8407 - Phone
- (601) 856-5986
- NPI assigned
- Jun 29, 2006
- Last updated
- Feb 9, 2016
- Sex
- Female
- 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 Medical Services (Emergency Medicine) Physician | 207PE0004X | 16045 | MS | Primary |
Addresses
Primary practice location
935 Highway 51
Madison, MS 39110-8407
Mailing address
308 Corporate Dr
Ridgeland, MS 39157-8803
Phone (601) 898-7500
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 00122742 | Medicaid | MS |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in MS
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- General Practice
- Education
- University of Mississippi School of Medicine, 1997
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
1265 Gluckstadt Rd
Suite B
Gluckstadt, MS 39110-7250
Phone (601) 859-8550
Hospital & facility affiliations
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 16045 | MS | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Quad Intermed Company LLC | Current | Accepting new patients | |
| Quad Intermed Company LLC | Current | Accepting new patients | |
| Quad Intermed Company LLC | Current | Accepting new patients | |
| Quad Intermed Company LLC | Past | Accepting new patients |
Locations
1265 Gluckstadt Rd
Ste B
Gluckstadt, MS 39110
Phone (601) 859-8550
935 Highway 51
Madison, MS 39110
Phone (601) 856-5986
342 Gilchrist Dr
Pearl, MS 39208
Phone (601) 939-0700
308 Corporate Dr
Ridgeland, MS 39157
Phone (601) 898-7500
4204 Clay St
Vicksburg, MS 39183
Phone (601) 200-4560
4204 Clay St
#V
Vicksburg, MS 39183
Phone (601) 619-7717
307 E Fifteenth St
Yazoo City, MS 39194
Phone (662) 746-2113
Interoperability endpoints
- landerson2546074@direct.casso.us.com
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.
-
- Clinic/Center
- Laurel, MS
- NPI 1952099913
-
dba MEA Medical Clinic Gluckstadt
- Family Medicine Physician
- Gluckstadt, MS
- NPI 1932998051
-
- Clinic/Center
- Yazoo City, MS
- NPI 1093403065
Hospital & facility affiliations 1
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- General Acute Care Hospital
- Jackson, MS
- NPI 1306876065
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1151539200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1454976000000",
"number": "1699703389",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "308 CORPORATE DR",
"city": "RIDGELAND",
"state": "MS",
"postal_code": "391578803",
"telephone_number": "601-898-7500",
"fax_number": "601-898-7577"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "935 HIGHWAY 51",
"city": "MADISON",
"state": "MS",
"postal_code": "391108407",
"telephone_number": "601-856-5986"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ANDERSON",
"first_name": "LISA",
"middle_name": "D",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-06-29",
"last_updated": "2016-02-09",
"status": "A"
},
"taxonomies": [
{
"code": "207PE0004X",
"taxonomy_group": "",
"desc": "Emergency Medicine, Emergency Medical Services",
"state": "MS",
"license": "16045",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "00122742",
"state": "MS"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Madison, MS
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 9, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.