Kaitlin Anderson, MD

Individual provider Active NPI Student in an Organized Health Care Education/Training Program · Macon, GA

NPI 1861205486 · NPPES record last updated Jan 28, 2025

Key facts

NPI
1861205486
Entity type
Individual (NPI type 1)
Primary specialty
Student in an Organized Health Care Education/Training Program 390200000X
Practice address
777 Hemlock St
Macon, GA 31201-2102
Phone
(478) 633-1000
NPI assigned
Jan 28, 2025
Sex
Female
Sole proprietor
No

Medicare participation

Medicare fee-for-service enrollment
Enrolled in SC
Eligible to order & refer
Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
I20251229000204 SC Order and Referring Only - Pediatric Medicine
Practitioner - Pediatric Medicine
2860988961

National Provider Directory

Medicare enrollment (NPD)
Yes
Credentials
Doctor of Medicine

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X Yes

Addresses

Primary practice location

777 Hemlock St
Macon, GA 31201-2102

Mailing address

777 Hemlock St
Macon, GA 31201-2102
Phone (478) 633-1000

Other providers in Macon, GA

All providers in Macon, GA · Student in an Organized Health Care Education/Training Program in Georgia

Sources for this page

Verify at the official NPI Registry.