Otis Anderson III, M.D.

Primary specialty

Child & Adolescent Psychiatry PhysicianTaxonomy code 2084P0804X

License

21754 Issued in MS

Practice address

5185 Getwell Rd
Southaven, MS 38671-9691

Phone

(662) 893-6300

NPI assigned

May 2, 2007

Last updated

Oct 13, 2011By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

HHS exclusion list flag

CMS’s directory marks this NPI as on an HHS exclusion list; no matching OIG record was found. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.

Credentials

Doctor of Medicine

Practice roles

Interoperability endpoints

• FHIR API: https://fhir-usa.unify.chbase.com/org/allihcs-9d312177

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.

• Aaa Psychiatric Services, PLLC

  • Psychiatric Hospital
  • Memphis, TN
  • NPI 1215324033
  Authorized official Same address or phone
• Alliance Healthcare System, Inc

  • Anesthesiology Physician
  • Holly Springs, MS
  • NPI 1104099472
  NPD (past)

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

{
    "created_epoch": "1178064000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1318464000000",
    "number": "1932321742",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5147 WEMBERLEY DRIVE",
            "city": "MEMPHIS",
            "state": "TN",
            "postal_code": "38125",
            "telephone_number": "901-240-8937"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5185 GETWELL RD",
            "city": "SOUTHAVEN",
            "state": "MS",
            "postal_code": "386719691",
            "telephone_number": "662-893-6300"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ANDERSON",
        "first_name": "OTIS",
        "name_prefix": "Dr.",
        "name_suffix": "III",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-05-02",
        "last_updated": "2011-10-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0804X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Child & Adolescent Psychiatry",
            "state": "MS",
            "license": "21754",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Parth Amin, O.D.
• Sumaiya Amin, MD
• Regina Gayle Ammons, LPC
• Ample Heart Homecare Services
• Olivia Sewell Anders, MS CF-SLP
• Zakiya Anderson
• Tonya Marie Andrews, PLPC, NCC
• Anesthesia Services Associates, PLLC.
• Appling Podiatry, PLLC
• Robert W Appling, D.P.M.

• Child & Adolescent Psychiatry Physician in Southaven, MS
• Providers in Southaven, MS by specialty
• Child & Adolescent Psychiatry Physician in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 13, 2011; 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.