Active NPI
David Brian Anderson, MS, ATC
- Athletic Trainer
- Greenwood, MS
National Provider Identifier
1942237656
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Athletic Trainer
- License
- AT0357
- Practice address
- 27015 Highway 430 S
Greenwood, MS 38930-9421 - Phone
- (601) 664-8185
- NPI assigned
- Jun 27, 2006
- 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 |
|---|---|---|---|---|
| Athletic Trainer | 2255A2300X | AT0357 | MS | Primary |
Addresses
Primary practice location
27015 Highway 430 S
Greenwood, MS 38930-9421
Mailing address
27015 Highway 430 S
Greenwood, MS 38930-9421
Phone (601) 664-8185
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| AT0357 | Other | MS | MS LIC. NUMBER |
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
- Credentials
- Master of Science
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| AT0357 | MS | MD | Athletic Trainer |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1151366400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1341273600000",
"number": "1942237656",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "27015 HIGHWAY 430 S",
"city": "GREENWOOD",
"state": "MS",
"postal_code": "389309421",
"telephone_number": "601-664-8185"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "27015 HIGHWAY 430 S",
"city": "GREENWOOD",
"state": "MS",
"postal_code": "389309421",
"telephone_number": "601-664-8185"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ANDERSON",
"first_name": "DAVID",
"middle_name": "BRIAN",
"name_prefix": "Mr.",
"credential": "MS, ATC",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-06-27",
"last_updated": "2012-07-03",
"status": "A"
},
"taxonomies": [
{
"code": "2255A2300X",
"taxonomy_group": "",
"desc": "Specialist/Technologist, Athletic Trainer",
"state": "MS",
"license": "AT0357",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MS LIC. NUMBER",
"identifier": "AT0357",
"state": "MS"
}
],
"endpoints": [],
"other_names": []
}Other providers in Greenwood, MS
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 3, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.