Angela Antonia Anderson, PSS

Primary specialty

Peer SpecialistTaxonomy code 175T00000X

License

THW000003687 Issued in OR

Practice address

1003 E Main St Ste 104
Medford, OR 97504

Phone

(541) 779-1282

Fax

(541) 608-2888

NPI assigned

Feb 1, 2016

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

Locations

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.

• Addictions Recovery Center, Inc.

  • Substance Abuse Rehabilitation Facility
  • Medford, OR
  • NPI 1346282035
  NPD

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

{
    "created_epoch": "1454284800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1580169600000",
    "number": "1851759245",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1003 E MAIN ST STE 104",
            "city": "MEDFORD",
            "state": "OR",
            "postal_code": "975047140",
            "telephone_number": "541-779-1282",
            "fax_number": "541-608-2888"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1003 E MAIN ST STE 104",
            "city": "MEDFORD",
            "state": "OR",
            "postal_code": "97504",
            "telephone_number": "541-779-1282",
            "fax_number": "541-608-2888"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ANDERSON",
        "first_name": "ANGELA",
        "middle_name": "ANTONIA",
        "credential": "PSS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-02-01",
        "last_updated": "2020-01-28",
        "certification_date": "2020-01-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "171M00000X",
            "taxonomy_group": "",
            "desc": "Case Manager/Care Coordinator",
            "state": "OR",
            "license": "THW000003687",
            "primary": false
        },
        {
            "code": "175T00000X",
            "taxonomy_group": "",
            "desc": "Peer Specialist",
            "state": "OR",
            "license": "THW000003687",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Casandra Lynn Anderrson, QMHA
• Anders Incorporated (aaron d anders physical therapy)
• Aaron Daniel Anders, MPT
• Lara Lisa Anders, MFT
• Elizabeth Anderson Allred, LCSW
• Becca Lee Anderson, BS, QMHA
• Carie Alise Leilani Anderson, NP, DNP
• Carolyn Diana Anderson
• Cassandra Anderson
• Charles Martin Anderson, D.C.

• Peer Specialist in Medford, OR
• Providers in Medford, OR by specialty
• Peer Specialist in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 28, 2020; 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.