Individual provider Active NPI

Todd W Anderson, DO

  • Family Medicine Physician
  • Houghton, MI
National Provider Identifier
1902126998
Registry record updated Apr 12, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
5101018614 Issued in MI
Practice address
600 Macinnes Dr
Houghton, MI 49931-1144
Phone
(906) 483-1860
Fax
(906) 483-1270
NPI assigned
Jun 2, 2010
Last updated
Apr 12, 2021By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 12, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 5101018614 MI Primary

Addresses

Primary practice location

600 Macinnes Dr
Houghton, MI 49931-1144

Mailing address

600 Macinnes Dr
Houghton, MI 49931-1144
Phone (906) 483-1860

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Aspirus KeweenawGroup PAC ID 8123912011, shared by 7 NPIs, 116 clinicians

Practice addresses (Care Compare)

205 Osceola St
Laurium, MI 49913-2134
Phone (906) 337-3100

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
5101018614MIMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Upper Great Lakes Family Health Center CurrentSince Jan 1, 2014 Accepting new patients
Upper Great Lakes Family Health Center CurrentSince Jan 1, 2014 Accepting new patients
Upper Great Lakes Family Health Center Family Medicine Current Accepting new patients

Locations

135 E State Highway M35
Gwinn, MI 49841
Phone (906) 346-9275

301 Explorer St
Gwinn, MI 49841
Phone (906) 346-4924

500 Campus Dr
Hancock, MI 49930
Phone (906) 483-1000

500 Campus Dr
Ste 5
Hancock, MI 49930
Phone (906) 483-1700

506 Campus Dr
Hancock, MI 49930
Phone (906) 483-1000

600 Macinnes Dr
Houghton, MI 49931
Phone (906) 483-1818

Organizations & group practices 3

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 4

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": "1275436800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1618185600000",
    "number": "1902126998",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "600 MACINNES DR",
            "city": "HOUGHTON",
            "state": "MI",
            "postal_code": "499311144",
            "telephone_number": "906-483-1860",
            "fax_number": "906-483-1270"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "600 MACINNES DR",
            "city": "HOUGHTON",
            "state": "MI",
            "postal_code": "499311144",
            "telephone_number": "906-483-1860",
            "fax_number": "906-483-1270"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ANDERSON",
        "first_name": "TODD",
        "middle_name": "W",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-06-02",
        "last_updated": "2021-04-12",
        "certification_date": "2021-04-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MI",
            "license": "5101018614",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Houghton, MI

Sources for this page

Verify at the official NPI Registry.