Preston Michael Anderson, DO
Individual provider Active NPI Family Medicine Physician · St George, UT
NPI 1902425333 · NPPES record last updated Jul 20, 2026
Key facts
- NPI
- 1902425333
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Family Medicine Physician 207Q00000X
- License
- 12404190-1204 (UT)
- Practice address
- 1739 W Sunset Blvd
St George, UT 84770-7141 - Phone
- (435) 634-6012
- NPI assigned
- Apr 15, 2020
- Sex
- Male
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
National Provider Directory
- Medicare enrollment (NPD)
- No
- Credentials
- Doctor of Osteopathy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 90863 | GA | MD | Family Medicine Physician |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | 90863 | GA | |
| Family Medicine Physician | 207Q00000X | 12404190-1204 | UT | Yes |
Addresses
Primary practice location
1739 W Sunset Blvd
St George, UT 84770-7141
Mailing address
PO Box 27128
Salt Lake City, UT 84127-0128
Other practice location 1
Landstuhl Regional Medical Center Unit 33100
Apo, AE 09180-3100
Phone (314) 483-6248
Electronic endpoints
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| CONNECT URL | https://esmd.officeally.io.8291/Gateway/DocumentSubmission/2_0/NhinService/XDRRequest_Service | Other | Bluemark LLC / Office Ally |
Other providers in St George, UT
- Michael Anderson
- Michelle Anderson
- Michelle L Anderson
- Paige Anderson
- Paul Darren Anderson
- Robert Brad Anderson
- Sadie Anderson
- Sarah Anderson
- Sharleen Anderson
- Stephanie Anderson
All providers in St George, UT · Family Medicine Physician in Utah
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 20, 2026. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.