Individual provider Active NPI

David Brian Anderson, D.C.

  • Chiropractor
  • W Palm Beach, FL
National Provider Identifier
1861474769
Registry record updated Apr 25, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
CH0006427 Issued in FL
Practice address
2790 N Military TRL
Ste 1
W Palm Beach, FL 33409
Phone
(561) 683-4971
Fax
(561) 478-4946
NPI assigned
Nov 16, 2005
Last updated
Apr 25, 2012By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 25, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X CH0006427 FL Primary

Addresses

Primary practice location

2790 N Military TRL
Ste 1
W Palm Beach, FL 33409

Mailing address

2790 N Military TRL
Ste 1
West Palm Beach, FL 33409
Phone (561) 683-4971

Other identifiers 7

IdentifierTypeStateIssuer
4481407OtherUNITED HEALTHCARE
5899670OtherGHI
7057015OtherFLAETNA
070217000MedicaidFL
22733OtherBLUE CROSS/BLUE SHIELD
350044666OtherMEDICARE RAILROAD
611357OtherACN NETWORK

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20121024000383 FL Practitioner - Chiropractic 4183874688 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Palmer College Chiropractic - Davenport, 1991
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

2790 N Military TRL
Suite 1
West Palm Beach, FL 33409-2926
Phone (561) 683-4971

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
CH0006427FLMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Northwood Sports Medicine & Physical Rehabilitation Inc CurrentSince Jun 17, 1998 Accepting new patients

Locations

2790 N Military Trl
Ste 1
West Palm Beach, FL 33409
Phone (561) 683-4971

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, 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": "1132099200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1335312000000",
    "number": "1861474769",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2790 N MILITARY TRL",
            "address_2": "STE 1",
            "city": "WEST PALM BEACH",
            "state": "FL",
            "postal_code": "33409",
            "telephone_number": "561-683-4971",
            "fax_number": "561-478-4946"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2790 N MILITARY TRL",
            "address_2": "STE 1",
            "city": "W PALM BEACH",
            "state": "FL",
            "postal_code": "33409",
            "telephone_number": "561-683-4971",
            "fax_number": "561-478-4946"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ANDERSON",
        "first_name": "DAVID",
        "middle_name": "BRIAN",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-11-16",
        "last_updated": "2012-04-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "FL",
            "license": "CH0006427",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITED HEALTHCARE",
            "identifier": "4481407",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GHI",
            "identifier": "5899670",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "7057015",
            "state": "FL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "070217000",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS/BLUE SHIELD",
            "identifier": "22733",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE RAILROAD",
            "identifier": "350044666",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ACN NETWORK",
            "identifier": "611357",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in W Palm Beach, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 25, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.