Christopher James Anderson, DPM
Individual provider Active NPI Foot Surgery Podiatrist · O'Fallon, IL
NPI 1790760494 · NPPES record last updated Oct 7, 2020
Key facts
- NPI
- 1790760494
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Foot Surgery Podiatrist 213ES0131X
- License
- 016.005443 (IL)
- Practice address
- 717 Insight Ave
Suite 100
O'Fallon, IL 62269 - Phone
- (618) 277-9533
- Fax
- (618) 277-9540
- NPI assigned
- Dec 14, 2005
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 9
Hospital & facility affiliations 2
Medicare Care Compare profile
- Specialty
- Podiatry
- Education
- William M. Scholl College of Podiatric Medicine, 1999
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- C James Anderson DPM LLC
Practice addresses (Care Compare)
1000 Eleven S
Suite 3a
Columbia, IL 62236-1077
Phone (618) 277-9533
Hospital & facility affiliations
- HSHS St Elizabeth'S Hospital
- Memorial Hospital
Merit-based Incentive Payment System (MIPS)
- Final score
- 75 of 100
Procedures performed for Medicare patients
| Procedure | Number of procedures |
|---|---|
| Removal of tissue | 168 |
| Removal of skin lesions | 51 |
| Removal of nail tissue | 1136 |
| Removal or shaving of skin growth | 520 |
| Skin biopsy | 1-10 |
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled (2 enrollments) in MO, IL
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: No · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20040712000761 | MO | Practitioner - Podiatry | 7012995475 | Reassigns benefits to 1 organization |
| I20110210000040 | IL | Practitioner - Podiatry | 7012995475 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- No
- HHS exclusion list flag
- The National Provider Directory flags this NPI as appearing on an HHS exclusion list.
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 016.005443 | IL | MD | Foot Surgery Podiatrist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| C James Anderson DPM LLC | Foot Surgery | Current |
Accepting new patients |
| C James Anderson DPM LLC | Foot Surgery | Current |
Accepting new patients |
| C James Anderson DPM LLC | Current |
Accepting new patients | |
| Albright Footcare Center LLC | Past | Accepting new patients | |
| C James Anderson DPM LLC | Foot Surgery | Past | Accepting new patients |
| Albright Footcare Center | Foot Surgery | Past | Accepting new patients |
| Affiliated Ankle and Foot Surgeons | Past | Accepting new patients | |
| Foot Healers Holdings - St. Louis, LLC | Foot Surgery | Past | Accepting new patients |
| Foot Healers Holdings - St. Louis, LLC | Foot Surgery | Past | Accepting new patients |
Locations
4600 Memorial Dr
Ste 300
Belleville, IL 62226
Phone (618) 233-3066
1000 Eleven S
Ste 3A
Columbia, IL 62236
Phone (618) 277-9533
717 Insight Ave
Ste 100
O Fallon, IL 62269
Phone (618) 277-9533
11710 Old Ballas Rd
Ste 110
Saint Louis, MO 63141
Phone (314) 567-1958
Interoperability endpoints
- https://api.platform.athenahealth.com/2451/brand/1/csg/1/fhir/r4
- https://fhir4.healow.com/fhir/r4/HGJJCA/Endpoint/HGJJCA
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Foot Surgery Podiatrist | 213ES0131X | 2010030718 | MO | |
| Foot Surgery Podiatrist | 213ES0131X | 016.005443 | IL | Yes |
Addresses
Primary practice location
717 Insight Ave
Suite 100
O'Fallon, IL 62269
Mailing address
717 Insight Ave
Suite 100
O'Fallon, IL 62269
Phone (618) 277-9533
Other providers in O'Fallon, IL
- Oluwadamilola Mercy Adegbenro
- Emilio Aguinaldo
- Esha Ahirwar
- Fatima Ahmad
- Jayden Patricia Ann Ashford
- Alan T Azar
- Scott Edwin Baer
- Bala Chiropractic
- Alicia Borawski
All providers in O'Fallon, IL · Foot Surgery Podiatrist in Illinois
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Oct 7, 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.