Carol J. Anderson, N.P. – Family Nurse Practitioner

Key facts

NPI: 1740255140
Entity type: Individual (NPI type 1)
Primary specialty: Family Nurse Practitioner 363LF0000X
License: 150448 (MA)
Practice address: 31 Hall Dr
Amherst Medical Center
Amherst, MA 01002-2751
Phone: (413) 256-8561
Fax: (413) 256-4421
NPI assigned: Feb 20, 2006
Sex: Female
Sole proprietor: No

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 and National Provider Directory roles.

Valley Medical Group, P.C. Family Medicine Physician · Greenfield, MA · NPI 1912924705

Medicare reassignment NPD FAMILY · MA
Valley Medical Group, P.C. Durable Medical Equipment & Medical Supplies · Easthampton, MA · NPI 1982738118

NPD

Medicare participation

Medicare fee-for-service enrollment: Enrolled in MA
Eligible to order & refer: Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No

Medicare enrollment records

Enrollment ID	State	Provider type	PAC ID	Details
I20060420000229	MA	Practitioner - Nurse Practitioner	6608885520	Reassigns benefits to 1 organization

National Provider Directory

Medicare enrollment (NPD): Yes
Credentials: Nurse Practitioner

State licenses

License	State	Type	Specialty
150448	MA	MD	Family Nurse Practitioner

Practice roles

Organization	Specialty	Status	New patients
Valley Medical Group, P.C.		Current since Feb 6, 2006	Accepting new patients
Valley Medical Group, P.C.	Family	Current since Feb 6, 2006	Accepting new patients

Locations

31 Hall Dr
Amherst, MA 01002
Phone (413) 256-8561

70 Main St
Northampton, MA 01062
Phone (413) 586-8400

Specialties & licenses

Specialty (taxonomy)	Code	License	State	Primary
Family Nurse Practitioner	363LF0000X	150448	MA	Yes

Addresses

Primary practice location

31 Hall Dr
Amherst Medical Center
Amherst, MA 01002-2751

Mailing address

PO Box 5700
Belfast, ME 04915-5700
Phone (866) 431-4077

Other identifiers

Identifier	Type	State	Issuer
123465	Other	MA	FALLON
NP1534	Other	MA	BLUE CROSS BLUE SHIELD
0351181	Medicaid	MA
150488	Other	MA	CONNECTICARE

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on Apr 19, 2013.

{
    "created_epoch": "1140393600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1366329600000",
    "number": "1740255140",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 5700",
            "city": "BELFAST",
            "state": "ME",
            "postal_code": "049155700",
            "telephone_number": "866-431-4077",
            "fax_number": "413-774-7448"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "31 HALL DR",
            "address_2": "AMHERST MEDICAL CENTER",
            "city": "AMHERST",
            "state": "MA",
            "postal_code": "010022751",
            "telephone_number": "413-256-8561",
            "fax_number": "413-256-4421"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ANDERSON",
        "first_name": "CAROL",
        "middle_name": "J.",
        "name_prefix": "Ms.",
        "credential": "N.P.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-02-20",
        "last_updated": "2013-04-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MA",
            "license": "150448",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "FALLON",
            "identifier": "123465",
            "state": "MA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "NP1534",
            "state": "MA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0351181",
            "state": "MA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CONNECTICARE",
            "identifier": "150488",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Amherst, MA

All providers in Amherst, MA · Family Nurse Practitioner in Massachusetts

Sources for this page

NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Apr 19, 2013. Information in NPPES is self-reported and not verified by CMS.
NUCC Health Care Provider Taxonomy: specialty names.
Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
Order and Referring (CMS).
National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.