NPIMap

Individual provider Active NPI

David Eric Anderson, M.D.

  • Internal Medicine Physician
  • Shelton, WA
National Provider Identifier
1780909556
Registry record updated Nov 16, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
MD044384 Issued in DC
Practice address
1701 N 13TH St
Shelton, WA 98584-2077
Phone
(360) 426-2653
NPI assigned
Apr 5, 2010
Last updated
Nov 16, 2020By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 16, 2020

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X MD60367274 WA
Internal Medicine Physician 207R00000X MD044384 DC Primary
Internal Medicine Physician 207R00000X 0101261586 VA

Addresses

Primary practice location

1701 N 13TH St
Shelton, WA 98584-2077

Mailing address

621 E Hague Rd
El Paso, TX 79902-2706
Phone (240) 620-3627

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA, VA2 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20130910000741 WA Practitioner - Internal Medicine 6406090679 Reassigns benefits to 1 organization
I20170410001877 VA Practitioner - Internal Medicine 6406090679 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Uniformed Services Uhs Fe Hebert School of Med, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

901 Mountain View Dr
Shelton, WA 98584-4401
Phone (360) 426-1611

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MD60367274WAMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Public Hospital District No 1 of Mason County Wa CurrentSince Jul 12, 2014 Accepting new patients
Public Hospital District No 1 of Mason County CurrentSince Jul 12, 2014 Accepting new patients

Locations

600 E Main St
Elma, WA 98541
Phone (360) 346-2222

1701 N 13th St
Shelton, WA 98584
Phone (360) 426-2653

237 Professional Way
Shelton, WA 98584
Phone (360) 426-2500

901 Mountain View Dr
Shelton, WA 98584
Phone (360) 426-1611

Interoperability endpoints

  • Direct secure messaging: danders073@direct.sp-mc.org

Organizations & group practices 3

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.

Hospital & facility affiliations 9

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1270425600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1605484800000",
    "number": "1780909556",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "621 E HAGUE RD",
            "city": "EL PASO",
            "state": "TX",
            "postal_code": "799022706",
            "telephone_number": "240-620-3627"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1701 N 13TH ST",
            "city": "SHELTON",
            "state": "WA",
            "postal_code": "985842077",
            "telephone_number": "360-426-2653"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ANDERSON",
        "first_name": "DAVID",
        "middle_name": "ERIC",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-04-05",
        "last_updated": "2020-11-16",
        "certification_date": "2020-11-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "WA",
            "license": "MD60367274",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "DC",
            "license": "MD044384",
            "primary": true
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "VA",
            "license": "0101261586",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Shelton, WA

Sources for this page

Verify at the official NPI Registry.