Individual provider Active NPI

Robert E Anderson, MD

  • Surgery Physician
  • Dakota Dunes, SD
National Provider Identifier
1831165307
Registry record updated Jan 22, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
License
3882 Issued in SD
Practice address
705 Sioux Point Rd
Suite 100
Dakota Dunes, SD 57049-5091
Phone
(605) 217-5500
Fax
(605) 217-5515
NPI assigned
Feb 24, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 22, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X 3882 SD Primary

Addresses

Primary practice location

705 Sioux Point Rd
Suite 100
Dakota Dunes, SD 57049-5091

Mailing address

705 Sioux Point Rd
Suite 100
Dakota Dunes, SD 57049-5091
Phone (605) 217-5500

Other identifiers 3

IdentifierTypeStateIssuer
7302050MedicaidSD
020029093OtherSDRRMEDICARE
0049510MedicaidIA

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
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
The Midlands Clinic, P.C. Current Accepting new patients

Locations

300 Sioux Valley Dr
Cherokee, IA 51012
Phone (712) 225-3368

705 N Sioux Point Rd
Ste 100
North Sioux City, SD 57049
Phone (605) 217-5566

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.

NPI Registry JSON

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

{
    "created_epoch": "1140739200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1264118400000",
    "number": "1831165307",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "705 SIOUX POINT RD",
            "address_2": "SUITE 100",
            "city": "DAKOTA DUNES",
            "state": "SD",
            "postal_code": "570495091",
            "telephone_number": "605-217-5500",
            "fax_number": "605-217-5515"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "705 SIOUX POINT RD",
            "address_2": "SUITE 100",
            "city": "DAKOTA DUNES",
            "state": "SD",
            "postal_code": "570495091",
            "telephone_number": "605-217-5500",
            "fax_number": "605-217-5515"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ANDERSON",
        "first_name": "ROBERT",
        "middle_name": "E",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-02-24",
        "last_updated": "2010-01-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "SD",
            "license": "3882",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7302050",
            "state": "SD"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RRMEDICARE",
            "identifier": "020029093",
            "state": "SD"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0049510",
            "state": "IA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Dakota Dunes, SD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 22, 2010; 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.