Active NPI
Michael Anderson
- Home Modifications Contractor
- Barron, WI
National Provider Identifier
1831764513
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Home Modifications Contractor
- License
- DC-082000806
- Practice address
- 417 S Mill St
Barron, WI 54812-1342 - Phone
- (715) 637-1011
- NPI assigned
- May 25, 2021
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Home Modifications Contractor | 171WH0202X | DC-082000806 | WI | Primary |
Addresses
Primary practice location
417 S Mill St
Barron, WI 54812-1342
Mailing address
417 S Mill St
Barron, WI 54812-1342
Phone (715) 637-1011
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)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| DC-082000806 | WI | MD | Home Modifications Contractor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1621900800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1621900800000",
"number": "1831764513",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "417 S MILL ST",
"city": "BARRON",
"state": "WI",
"postal_code": "548121342",
"telephone_number": "715-637-1011"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "417 S MILL ST",
"city": "BARRON",
"state": "WI",
"postal_code": "548121342",
"telephone_number": "715-637-1011"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ANDERSON",
"first_name": "MICHAEL",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2021-05-25",
"last_updated": "2021-05-25",
"certification_date": "2021-05-25",
"status": "A"
},
"taxonomies": [
{
"code": "171WH0202X",
"taxonomy_group": "",
"desc": "Contractor, Home Modifications",
"state": "WI",
"license": "DC-082000806",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Barron, WI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 25, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.