Russell Dan Anderson, RN

Primary specialty

Critical Care Medicine Registered NurseTaxonomy code 163WC0200X

License

9433286 Issued in FL

Practice address

4428 SW 105TH Dr
Gainesville, FL 32608-7139

Phone

(941) 735-1790

NPI assigned

Sep 10, 2020

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

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Registered Nurse

State licenses

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

{
    "created_epoch": "1599696000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1599696000000",
    "number": "1740895473",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4428 SW 105TH DR",
            "city": "GAINESVILLE",
            "state": "FL",
            "postal_code": "326087139",
            "telephone_number": "941-735-1790"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4428 SW 105TH DR",
            "city": "GAINESVILLE",
            "state": "FL",
            "postal_code": "326087139",
            "telephone_number": "941-735-1790"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ANDERSON",
        "first_name": "RUSSELL",
        "middle_name": "DAN",
        "credential": "RN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-09-10",
        "last_updated": "2020-09-10",
        "certification_date": "2020-09-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WC0200X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Critical Care Medicine",
            "state": "FL",
            "license": "9433286",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Pepper Anderson
• R. David Anderson, MD
• Rachel M Anderson, L.M.T.
• Rhys J Anderson, CTRS
• Richard V Anderson
• Ryan Maurice Anderson, RN
• Shaun Michael Anderson
• Shawn David Anderson, PHARM.D.
• Stephanie Daisy Anderson, MD
• Susanne Miller Anderson, M.D.

• Critical Care Medicine Registered Nurse in Gainesville, FL
• Providers in Gainesville, FL by specialty
• Critical Care Medicine Registered Nurse in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 10, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.