NPIMap

Individual provider Active NPI

Eric Buckley Anderson, MD

  • Hematology & Oncology Physician
  • Douglas, GA
National Provider Identifier
1891741757
Registry record updated Jun 23, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Hematology & Oncology PhysicianTaxonomy code 207RH0003X
License
051577 Issued in GA
Practice address
903 Ward St W Ste B
Douglas, GA 31533-3536
Phone
(912) 384-4111
Fax
(912) 384-4115
NPI assigned
May 25, 2006
Last updated
Jun 23, 2022By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 23, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Hematology & Oncology Physician 207RH0003X 051577 GA Primary

Addresses

Primary practice location

903 Ward St W Ste B
Douglas, GA 31533-3536

Mailing address

PO Box 1377
Douglas, GA 31534
Phone (912) 389-2231

Other practice location 1

1508 Tebeau St
Waycross, GA 31501-5327
Phone (912) 384-4111

Other identifiers 2

IdentifierTypeStateIssuer
00955237CMedicaidGA
051577OtherGAMEDICAL LICENSE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20110105000936 GA Practitioner - Hematology/OncologyPractitioner - Internal Medicine 7315136462 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Hematology/OncologyAlso: Internal Medicine
Education
Medical College of Georgia School of Medicine, 1996
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
CRH Physician Practices, LLCGroup PAC ID 5193727964, 38 clinicians

Practice addresses (Care Compare)

903 Ward St W
Suite B
Douglas, GA 31533-3536
Phone (912) 384-4111

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
CRH Physician Practices, LLC CurrentSince Aug 26, 2017 Accepting new patients
Eric Anderson MDPC Hematology & Oncology Past Accepting new patients
CRH Physician Practices LLC Past Accepting new patients
Douglas Hematology Oncology Associates Hematology & Oncology Past Accepting new patients

Locations

1100 Ward Street Ext W
Douglas, GA 31533
Phone (912) 384-1470

200 Doctors Dr
Ste L
Douglas, GA 31533
Phone (912) 383-5682

903 Ward St W
Ste B
Douglas, GA 31533
Phone (912) 384-4030

1508 Tebeau St
Waycross, GA 31501
Phone (912) 383-6575

Interoperability endpoints

  • Direct secure messaging: eric.anderson.1@9964.direct.athenahealth.com

Organizations & group practices 4

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.

Hospital & facility affiliations 5

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1148515200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1655942400000",
    "number": "1891741757",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1377",
            "city": "DOUGLAS",
            "state": "GA",
            "postal_code": "31534",
            "telephone_number": "912-389-2231",
            "fax_number": "912-384-1470"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "903 WARD ST W STE B",
            "city": "DOUGLAS",
            "state": "GA",
            "postal_code": "315333536",
            "telephone_number": "912-384-4111",
            "fax_number": "912-384-4115"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1508 Tebeau St",
            "address_purpose": "LOCATION",
            "city": "Waycross",
            "state": "GA",
            "postal_code": "315015327",
            "country_code": "US",
            "telephone_number": "912-384-4111",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ANDERSON",
        "first_name": "ERIC",
        "middle_name": "BUCKLEY",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-25",
        "last_updated": "2022-06-23",
        "certification_date": "2022-06-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RH0003X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Hematology & Oncology",
            "state": "GA",
            "license": "051577",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00955237C",
            "state": "GA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAL LICENSE",
            "identifier": "051577",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Douglas, GA

Sources for this page

Verify at the official NPI Registry.