Andrew Anderson
Individual provider Active NPI Family Nurse Practitioner · Gladstone, MI
NPI 1780200022 · NPPES record last updated Jun 23, 2020
Key facts
- NPI
- 1780200022
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Family Nurse Practitioner 363LF0000X
- License
- 4704297360 (MI)
- Practice address
- 208 Michigan Ave
Gladstone, MI 49837-1914 - Phone
- (906) 241-7436
- NPI assigned
- Jun 23, 2020
- Sex
- Male
- Sole proprietor
- Yes
Organizations & group practices 7
Hospital & facility affiliations 4
Medicare Care Compare profile
- Specialty
- Nurse Practitioner
- Education
- Other, 2020
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Schoolcraft Memorial Hospital
Practice addresses (Care Compare)
7870W US Hwy 2
Manistique, MI 49854-8992
Phone (906) 341-2153
Hospital & facility affiliations
- Schoolcraft Memorial Homecare and Hospice
- North Woods Home Nursing
- Schoolcraft Memorial Hospital
- Helen Newberry Joy Hospital
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in MI
- 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 |
|---|---|---|---|---|
| I20201105000754 | MI | Practitioner - Nurse Practitioner | 3779993514 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 4704297360 | MI | MD | Family Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Schoolcraft Memorial Hospital | Current | Accepting new patients | |
| Schoolcraft Memorial Hospital | Past | Accepting new patients | |
| Helen Newberry Joy Hospital & Healthcare Center | Past | Accepting new patients |
Locations
7870W US Highway 2
Manistique, MI 49854
Phone (906) 341-2153
Interoperability endpoints
- https://fhir-myrecord.cerner.com/r4/71812193-7aa5-42d8-ba4c-ee45e2ea853f/
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Nurse Practitioner | 363LF0000X | 4704297360 | MI | Yes |
Addresses
Primary practice location
208 Michigan Ave
Gladstone, MI 49837-1914
Mailing address
208 Michigan Ave
Gladstone, MI 49837-1914
Phone (906) 241-7436
Other providers in Gladstone, MI
- Adult Family & Group Counseling PLLC
- Martha Alling
- Michael John Ballard
- Richard Blakeslee Ballard
- Bay de Noc Chiropractic Center, P.C.
- Beacon Specialized Living Services
- Bellin Health Iron Mountain Inc
All providers in Gladstone, MI · Family Nurse Practitioner in Michigan
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jun 23, 2020. 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).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.