John Pershing Anderson Jr., DMD

Primary specialty

DentistTaxonomy code 122300000X

License

3022 Issued in AL

Practice address

89 Church Ave
Rainsville, AL 35986-0646

Phone

(256) 638-4436

Fax

(256) 638-7212

NPI assigned

Dec 6, 2006

Last updated

Jul 8, 2007By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in AL

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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.

• Dr. John Anderson

  • Dentist
  • Rainsville, AL
  • NPI 1407202476
  NPD (past) Authorized official

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

{
    "created_epoch": "1165363200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1700945631",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 646",
            "city": "RAINSVILLE",
            "state": "AL",
            "postal_code": "35986",
            "telephone_number": "256-638-4436",
            "fax_number": "256-638-7212"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "89 CHURCH AVE",
            "city": "RAINSVILLE",
            "state": "AL",
            "postal_code": "359860646",
            "telephone_number": "256-638-4436",
            "fax_number": "256-638-7212"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ANDERSON",
        "first_name": "JOHN",
        "middle_name": "PERSHING",
        "name_prefix": "Dr.",
        "name_suffix": "Jr.",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-12-06",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "AL",
            "license": "3022",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "90122",
            "state": "AL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Abc Hospice, Inc
• Amedisys Home Health of Alabama, LLC (Adoration Home Health)
• As Close As Family
• Zachary James Beason
• Jansen Robb Blackwell, DO
• January Blalock, CRNP
• Andrea W Boswell, PHARMD

• Dentist in Rainsville, AL
• Providers in Rainsville, AL by specialty
• Dentist in Alabama

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.