Christian B Anderson, D.O.

Primary specialty

MOHS-Micrographic Surgery PhysicianTaxonomy code 207ND0101X

License

7168A Issued in WY

Practice address

272 East Center Street Suite 102
Ivins, UT 84738-6456

Phone

(307) 413-3752

NPI assigned

Jan 29, 2007

Last updated

Sep 18, 2024By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in UT

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Dermatology

Education

Other, 2005

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy, Doctor of Medicine

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.

• Desert Dermatology and Surgery LLC

  • MOHS-Micrographic Surgery Physician
  • Ivins, UT
  • NPI 1902626047
  Medicare reassignment NPD Authorized official
• Arizona Desert Dermatology and Surgery PC

  • Dermatology Physician
  • Kingman, AZ
  • NPI 1386702546
  NPD (past)

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

{
    "created_epoch": "1170028800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1726617600000",
    "number": "1861538860",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "756 W SHINAVA DR",
            "city": "IVINS",
            "state": "UT",
            "postal_code": "847386713",
            "telephone_number": "307-413-3752"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "272 EAST CENTER STREET SUITE 102",
            "city": "IVINS",
            "state": "UT",
            "postal_code": "847386456",
            "telephone_number": "307-413-3752"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ANDERSON",
        "first_name": "CHRISTIAN",
        "middle_name": "B",
        "name_prefix": "Mr.",
        "credential": "D.O.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-01-29",
        "last_updated": "2024-09-18",
        "certification_date": "2024-09-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207ND0101X",
            "taxonomy_group": "",
            "desc": "Dermatology, MOHS-Micrographic Surgery",
            "state": "WY",
            "license": "7168A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LISCENSE NUMBER",
            "identifier": "7168A",
            "state": "WY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LISCENSE NUMBER",
            "identifier": "12134634-1204",
            "state": "UT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Donna Alexander, MS, CCC-SLP
• Karlie Amen
• At Home Care and Health Services
• At Home Care and Health Services LLC
• Avalon Care Center - VA Ivins LLC (Southern Utah Veterans Home - Ivins)
• Maged Ayad, DO
• Susan Michelle Baker, DDS

• MOHS-Micrographic Surgery Physician in Ivins, UT
• Providers in Ivins, UT by specialty
• MOHS-Micrographic Surgery Physician in Utah

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 18, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• 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.