Individual provider Active NPI

Rodney Dale Anderson, DC

  • Chiropractor
  • Payson, AZ
National Provider Identifier
1932295110
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
3751 Issued in AZ
Practice address
903 N Beeline Hwy Ste B
Payson, AZ 85541-3789
Phone
(928) 474-7070
Fax
(928) 474-9450
NPI assigned
Oct 5, 2006
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 3751 AZ Primary

Addresses

Primary practice location

903 N Beeline Hwy Ste B
Payson, AZ 85541-3789

Mailing address

PO Box 1318
Payson, AZ 85547-1318
Phone (928) 474-7070

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AZ2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20070124000763 AZ Practitioner - Chiropractic 2668473240
I20240906001693 AZ Practitioner - Chiropractic 2668473240 Practice locations: Payson, AZ

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Logan College of Chiropractic, 1977
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

600 E St Hwy 260
Suite 5
Payson, AZ 85541

600 E State Hwy 260
Suite 5
Payson, AZ 85541-4967
Phone (928) 474-7070

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
3751AZMDClinical Psychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Rampertab Podiatry Onsite Podiatry Services Past Accepting new patients

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.

NPI Registry JSON

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

{
    "created_epoch": "1160006400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1932295110",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1318",
            "city": "PAYSON",
            "state": "AZ",
            "postal_code": "855471318",
            "telephone_number": "928-474-7070",
            "fax_number": "928-474-9450"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "903 N BEELINE HWY STE B",
            "city": "PAYSON",
            "state": "AZ",
            "postal_code": "855413789",
            "telephone_number": "928-474-7070",
            "fax_number": "928-474-9450"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ANDERSON",
        "first_name": "RODNEY",
        "middle_name": "DALE",
        "credential": "DC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-05",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "AZ",
            "license": "3751",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Payson, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • 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.

Verify at the official NPI Registry.