Active NPI
Kevin M Anderson, M.D.
- Family Medicine Physician
- Black River Falls, WI
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- License
- 47711
- Practice address
- 610 W Adams St
Black River Falls, WI 54615-9010 - Phone
- (715) 284-4311
- Fax
- (715) 284-2568
- NPI assigned
- Jul 19, 2006
- Last updated
- Jun 30, 2025
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | 47711 | WI | Primary |
Addresses
Primary practice location
610 W Adams St
Black River Falls, WI 54615-9010
Mailing address
610 W Adams St
Black River Falls, WI 54615-9010
Phone (715) 284-4311
Other practice location 1
711 W Adams St
Black River Falls, WI 54615-5052
Phone (715) 284-5361
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 34646600 | Medicaid | WI |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in WI, CO
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 2
Care Compare profile
Medicare Care Compare- Specialty
- Family Practice
- Education
- Saint Louis University School of Medicine, 1998
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
711 W Adams St
Black River Falls, WI 54615-5052
Phone (715) 284-5361
711 W Adams St
Black River Falls, WI 54615-9108
724 Rose St
Black River Falls, WI 54615-9278
Hospital & facility affiliations
- Interim Healthcare of Western Wisconsin
- St Croix Hospice Eau Claire
- Black River Memorial Hospital
- Meadowbrook at Black River Falls
Merit-based Incentive Payment System (MIPS)
- Final score
- 89.18 of 100
- Quality
- 87.29
- Promoting interoperability
- 100
- Improvement activities
- 40
- Cost
- 65.34
Procedures performed for Medicare patients
| Procedure | Number of procedures |
|---|---|
| Removal or shaving of skin growth | 1-10 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 47711 | WI | MD | Family Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Black River Health Inc | Current | Accepting new patients | |
| Black River Health Inc | Current | Accepting new patients | |
| Optumcare Colorado Medical Group LLC | Current | Accepting new patients | |
| Krohn Clinic LTD. | Family Medicine | Current | Accepting new patients |
| Black River Health Inc | Current | Accepting new patients | |
| Optumcare Colorado Medical Group LLC | Current | Accepting new patients |
Locations
1625 Medical Center Pt
Ste 290
Colorado Springs, CO 80907
Phone (719) 635-5148
2 S Cascade Ave
Ste 140
Colorado Springs, CO 80903
Phone (719) 538-2900
15909 Jackson Creek Pkwy
Monument, CO 80132
Phone (719) 481-0899
610 W Adams St
Blk River Fls, WI 54615
Phone (715) 284-4311
711 W Adams St
Blk River Fls, WI 54615
Phone (715) 284-3604
Interoperability endpoints
- https://fhir4.healow.com/fhir/r4/BHJBDA
- kevin.anderson@kcld.eclinicaldirectplus.com
Organizations & group practices 6
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.
-
- Critical Access Hospital
- Black River Falls, WI
- NPI 1811940331
-
- Family Medicine Physician
- Black River Falls, WI
- NPI 1790777621
-
dba Optum Colorado Springs
- General Practice Physician
- Colorado Springs, CO
- NPI 1407252828
-
dba Black River Healthcare Clinic
- Rural Health Clinic/Center
- Black River Falls, WI
- NPI 1255183182
-
- Oxygen Equipment & Supplies (DME)
- Black River Falls, WI
- NPI 1285782250
-
dba Colorado Center for Arthritis & Osteoporosis
- Rheumatology Physician
- Boulder, CO
- NPI 1922893478
Hospital & facility affiliations 4
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- Critical Access Hospital
- Black River Falls, WI
- NPI 1811940331
-
dba Meadowbrook at Black River Falls
- Skilled Nursing Facility
- Black River Falls, WI
- NPI 1164072898
Nursing home
-
dba Interim HealthCare of Western Wisconsin
- Home Health Agency
- Hudson, WI
- NPI 1770675712
-
dba St. Croix Hospice
- Community Based Hospice Care Agency
- Eau Claire, WI
- NPI 1841601952
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1153267200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1751241600000",
"number": "1932129665",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "610 W ADAMS ST",
"city": "BLACK RIVER FALLS",
"state": "WI",
"postal_code": "546159010",
"telephone_number": "715-284-4311",
"fax_number": "715-284-2568"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "610 W ADAMS ST",
"city": "BLACK RIVER FALLS",
"state": "WI",
"postal_code": "546159010",
"telephone_number": "715-284-4311",
"fax_number": "715-284-2568"
}
],
"practiceLocations": [
{
"address_1": "711 W Adams St",
"address_purpose": "LOCATION",
"city": "Black River Falls",
"state": "WI",
"postal_code": "546155052",
"country_code": "US",
"telephone_number": "715-284-5361",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "ANDERSON",
"first_name": "KEVIN",
"middle_name": "M",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-07-19",
"last_updated": "2025-06-30",
"certification_date": "2025-06-30",
"status": "A"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "WI",
"license": "47711",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "34646600",
"state": "WI"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Black River Falls, WI
- Advanced Chiropractic and Laser Centers, Inc (Advanced Chiropractic)
- Advanced Chiropractic Clinics Inc (Advanced Chiropractic)
- Advanced Mobility LLC
- Autumn L Alekna, APSW, MSW
- Rebecca L Amberg, LM RN
- Rebecca H Anderson, MSPT
- Jeremy S Anger
- Darrin Antonelli, M.D.
- Stacy L. Armitage, OCCUPATIONAL THERAPI
- Art of Optometry LTD
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 30, 2025; 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.