Individual provider Active NPI

Robert Ray Anderson, DC

  • Chiropractor
  • Reedsburg, WI
National Provider Identifier
1831185669
Registry record updated Aug 31, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
1736 Issued in WI
Practice address
346 2ND St
Reedsburg, WI 53959-1611
Phone
(608) 524-2616
Fax
(608) 524-3697
NPI assigned
Sep 27, 2005
Last updated
Aug 31, 2016By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 31, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 1736 WI Primary

Addresses

Primary practice location

346 2ND St
Reedsburg, WI 53959-1611

Mailing address

420 Viking Dr
Reedsburg, WI 53959-1675
Phone (608) 524-2616

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

State licenses

LicenseStateTypeSpecialty
1736WIMDSurgical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Interventional Pain Management of Northern Illinois Chiropractor Current Accepting new patients
Anderson Chiropractic Office, SC Chiropractor PastSince Jan 1, 1966 Accepting new patients

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1127779200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1472601600000",
    "number": "1831185669",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "420 VIKING DR",
            "city": "REEDSBURG",
            "state": "WI",
            "postal_code": "539591675",
            "telephone_number": "608-524-2616",
            "fax_number": "608-524-3697"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "346 2ND ST",
            "city": "REEDSBURG",
            "state": "WI",
            "postal_code": "539591611",
            "telephone_number": "608-524-2616",
            "fax_number": "608-524-3697"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ANDERSON",
        "first_name": "ROBERT",
        "middle_name": "RAY",
        "name_prefix": "Dr.",
        "credential": "DC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-09-27",
        "last_updated": "2016-08-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "WI",
            "license": "1736",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Reedsburg, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 31, 2016; 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.