Kittery Anderson

Primary specialty

Registered NurseTaxonomy code 163W00000X

License

200274 Issued in ND

Practice address

2101 Elm St N
Fargo, ND 58102-2498

Phone

(701) 232-3241

NPI assigned

Jul 21, 2021

Reactivated

Sep 3, 2024

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• Dakota Home Care, Inc.

  • Nursing Care Agency
  • Bismarck, ND
  • NPI 1780959809
  NPD (past)

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

{
    "created_epoch": "1626825600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1725321600000",
    "number": "1811560485",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1207 10TH AVENUE CIR",
            "city": "BARNESVILLE",
            "state": "MN",
            "postal_code": "565144015",
            "telephone_number": "701-270-7757"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2101 ELM ST N",
            "city": "FARGO",
            "state": "ND",
            "postal_code": "581022498",
            "telephone_number": "701-232-3241"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1207 10th Avenue Cir",
            "address_purpose": "LOCATION",
            "city": "Barnesville",
            "state": "MN",
            "postal_code": "565144015",
            "country_code": "US",
            "telephone_number": "701-270-7757",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ANDERSON",
        "first_name": "KITTERY",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-07-21",
        "last_updated": "2024-09-03",
        "certification_date": "2024-09-03",
        "deactivation_date": "2024-08-20",
        "reactivation_date": "2024-09-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "ND",
            "license": "200274",
            "primary": true
        },
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "ND",
            "license": "L17376",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Joan M Anderson, LICSW
• Joelle Denise Anderson, OTR/L
• Jon D Anderson, DDS
• Justin Earl Anderson, DPT
• Kalli Anderson
• Leah Anderson
• Lindsay Nichole Anderson, PH.D.
• Logan Anderson
• Marie E Anderson, SLP
• Marla Lister Anderson

• All providers in Fargo, ND
• Registered Nurse in North Dakota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 3, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.