Scott Gordon Anderson

Primary specialty

Peer SpecialistTaxonomy code 175T00000X

License

177 Issued in WY

Practice address

450 S Federal Blvd
Riverton, WY 82501-4711

Phone

(307) 856-8090

Fax

(307) 463-4254

NPI assigned

Dec 17, 2024

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1734393600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1735776000000",
    "number": "1821805375",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 190",
            "city": "ST STEPHENS",
            "state": "WY",
            "postal_code": "825240190",
            "telephone_number": "307-856-8090",
            "fax_number": "307-463-4254"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "450 S FEDERAL BLVD",
            "city": "RIVERTON",
            "state": "WY",
            "postal_code": "825014711",
            "telephone_number": "307-856-8090",
            "fax_number": "307-463-4254"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ANDERSON",
        "first_name": "SCOTT",
        "middle_name": "GORDON",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2024-12-17",
        "last_updated": "2025-01-02",
        "certification_date": "2025-01-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "175T00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Peer Specialist",
            "state": "WY",
            "license": "177",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Tracy L Ammann, O.D.
• Virgil R. Amos, P.A.T.
• Ruth A. Amsbaugh, M.A., L.M.F.T.
• Hailee Anderson, PHARM D.
• Kyle Leslie Anderson, FNP-C
• Tara Ann Anderson, PTA
• Artistry Med Spa & Aesthetics
• Jennifer Atene
• Allie T Austin
• Paul Alan Axthelm, DDS

• All providers in Riverton, WY
• Peer Specialist in Wyoming

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 2, 2025; 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.