Individual provider Active NPI

Gerelda Arlene Anderson

  • Transportation Broker
  • Millington, TN
National Provider Identifier
1912615600
Registry record updated Nov 10, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Transportation BrokerTaxonomy code 347E00000X
License
210008491 Issued in TN
Practice address
6358 Friendship Church Rd
Millington, TN 38053-7430
Phone
(615) 746-7173
NPI assigned
Nov 10, 2022
Last updated
Nov 10, 2022By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 10, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Transportation Broker 347E00000X 210008491 TN Primary

Addresses

Primary practice location

6358 Friendship Church Rd
Millington, TN 38053-7430

Mailing address

6358 Friendship Church Rd
Millington, TN 38053-7430
Phone (615) 746-7173

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
210008491TNMDTransportation Broker

NPI Registry JSON

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

{
    "created_epoch": "1668038400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1668038400000",
    "number": "1912615600",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6358 FRIENDSHIP CHURCH RD",
            "city": "MILLINGTON",
            "state": "TN",
            "postal_code": "380537430",
            "telephone_number": "615-746-7173"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6358 FRIENDSHIP CHURCH RD",
            "city": "MILLINGTON",
            "state": "TN",
            "postal_code": "380537430",
            "telephone_number": "615-746-7173"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ANDERSON",
        "first_name": "GERELDA",
        "middle_name": "ARLENE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-11-10",
        "last_updated": "2022-11-10",
        "certification_date": "2022-11-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "347E00000X",
            "taxonomy_group": "",
            "desc": "Transportation Broker",
            "state": "TN",
            "license": "210008491",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Millington, TN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 10, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.