Active NPI
John Theodore Anderson, ARNP
- Nurse Practitioner
- Templeton, IA
National Provider Identifier
1790022697
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Nurse Practitioner
- License
- A-108960
- Practice address
- 104 E 3Rd St
Templeton, IA 51463-5027 - Phone
- (712) 669-3894
- NPI assigned
- Jan 11, 2013
- Sex
- Male
- Sole proprietor
- No
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.
-
- Family Medicine Physician
- Fishkill, NY
- NPI 1043358815
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| A-108960 | IA | MD | Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Mid- Hudson Medical Group P C | Past | Accepting new patients |
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Nurse Practitioner | 363L00000X | A-108960 | IA | Primary |
Addresses
Primary practice location
104 E 3Rd St
Templeton, IA 51463-5027
Mailing address
2221 Elm St
Rawlins, WY 82301-5108
Phone (307) 324-2221
NPI Registry JSON
{
"created_epoch": "1357862400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1504137600000",
"number": "1790022697",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2221 ELM ST",
"city": "RAWLINS",
"state": "WY",
"postal_code": "823015108",
"telephone_number": "307-324-2221"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "104 E 3RD ST",
"city": "TEMPLETON",
"state": "IA",
"postal_code": "514635027",
"telephone_number": "712-669-3894"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ANDERSON",
"first_name": "JOHN",
"middle_name": "THEODORE",
"credential": "ARNP",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2013-01-11",
"last_updated": "2017-08-31",
"status": "A"
},
"taxonomies": [
{
"code": "363L00000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner",
"state": "IA",
"license": "A-108960",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Templeton, IA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 31, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.