Kathy M Anderson, M.D.

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

11368 Issued in ND

Practice address

1930 Burnt Boat Dr.
Suite B
Bismarck, ND 58503

Phone

(701) 490-9596

NPI assigned

Jun 19, 2007

Last updated

Jan 6, 2025By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in ND

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://api.platform.athenahealth.com/26013/brand/1/csg/1/fhir/r4
• Direct secure messaging: kathy.anderson.1@26013.direct.athenahealth.com

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.

• Nurturing Wellness Pediatrics, PLLC

  • Pediatrics Physician
  • Bismarck, ND
  • NPI 1619503760

  Single Specialty

  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1182211200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1736121600000",
    "number": "1942405923",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1930 BURNT BOAT DR.",
            "address_2": "SUITE B",
            "city": "BISMARCK",
            "state": "ND",
            "postal_code": "58503",
            "telephone_number": "701-490-9596"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1930 BURNT BOAT DR.",
            "address_2": "SUITE B",
            "city": "BISMARCK",
            "state": "ND",
            "postal_code": "58503",
            "telephone_number": "701-490-9596"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5119 Fountainblue Dr",
            "address_purpose": "LOCATION",
            "city": "Bismarck",
            "state": "ND",
            "postal_code": "585038893",
            "country_code": "US",
            "telephone_number": "401-952-0293",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ANDERSON",
        "first_name": "KATHY",
        "middle_name": "M",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-06-19",
        "last_updated": "2025-01-06",
        "certification_date": "2020-05-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "ND",
            "license": "11368",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1460870",
            "state": "ND"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Daniel Ernest Anderson, D.C.
• Danielle Rae Anderson, PA-C
• Elizabeth Anderson, MS, LPCC
• Elizabeth A Anderson
• Jamie R Anderson, LBSW
• Kelsey Kaye Lang Anderson, LPCC
• Kevin Anderson
• Maria Del Pilar Anderson
• Natalie Anderson
• Tanner Anderson, MD

• Pediatrics Physician in Bismarck, ND
• Providers in Bismarck, ND by specialty
• Pediatrics Physician in North Dakota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 6, 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.