Individual provider Active NPI

Andrew Christopher Anderson, M.D.

  • Family Medicine Physician
  • Columbus, GA
National Provider Identifier
1760747729
Registry record updated Jul 5, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
05751 Issued in GA
Practice address
1800 10TH Ave
Columbus, GA 31901-1513
Phone
(706) 571-1120
Fax
(706) 571-1603
NPI assigned
Jul 5, 2012
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 5, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 05751 GA Primary

Addresses

Primary practice location

1800 10TH Ave
Columbus, GA 31901-1513

Mailing address

1900 10TH Ave
Suite 100
Columbus, GA 31901-3600
Phone (706) 571-1430

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20160701001230 GA Practitioner - Hospice/Palliative Care 0547496929 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
05751GAMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
The Emory Clinic Inc CurrentSince Jul 1, 2016 Accepting new patients

Locations

1365 Clifton Rd NE
Atlanta, GA 30322
Phone (404) 778-7525

101 W Ponce de Leon Ave
Decatur, GA 30030
Phone (404) 778-4889

Organizations & group practices 1

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": "1341446400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1341446400000",
    "number": "1760747729",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1900 10TH AVE",
            "address_2": "SUITE 100",
            "city": "COLUMBUS",
            "state": "GA",
            "postal_code": "319013600",
            "telephone_number": "706-571-1430",
            "fax_number": "706-571-1604"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1800 10TH AVE",
            "city": "COLUMBUS",
            "state": "GA",
            "postal_code": "319011513",
            "telephone_number": "706-571-1120",
            "fax_number": "706-571-1603"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ANDERSON",
        "first_name": "ANDREW",
        "middle_name": "CHRISTOPHER",
        "name_prefix": "Mr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-07-05",
        "last_updated": "2012-07-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "GA",
            "license": "05751",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Columbus, GA

Sources for this page

Verify at the official NPI Registry.