David Michael Anderson II, MD

Primary specialty

Addiction Medicine (Preventive Medicine) PhysicianTaxonomy code 2083A0300X

License

46107 Issued in KY

Practice address

9702 Stonestreet Rd Ste 120
Louisville, KY 40272-6812

Phone

(866) 934-7450

NPI assigned

Jun 9, 2008

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 5

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in KY

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

Specialty

Interventional Pain Management

Education

University of Louisville School of Medicine, 2008

Medicare assignment

May accept Medicare assignment

Group practices

Cleanslate Medical Group of Kentucky PLLCGroup PAC ID 4486909769, 18 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Cleanslate Medical Group of Kentucky PLLC

  • Addiction Medicine (Internal Medicine) Physician
  • Louisville, KY
  • NPI 1538600630
  Medicare reassignment Care Compare group NPD
• Brightview, LLC

  • Addiction Medicine (Internal Medicine) Physician
  • Cincinnati, OH
  • NPI 1659769446

  KY

  Medicare reassignment

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

{
    "created_epoch": "1212969600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1712880000000",
    "number": "1962661488",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4600 MONTGOMERY RD STE 400",
            "city": "CINCINNATI",
            "state": "OH",
            "postal_code": "452122600",
            "fax_number": "502-233-4919"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9702 STONESTREET RD STE 120",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402726812",
            "telephone_number": "866-934-7450"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "6400 Dutchmans Pkwy Ste 600",
            "address_purpose": "LOCATION",
            "city": "Louisville",
            "state": "KY",
            "postal_code": "402053340",
            "country_code": "US",
            "telephone_number": "812-477-7246 x6001",
            "fax_number": "812-477-7240",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "5722 Outer Loop",
            "address_purpose": "LOCATION",
            "city": "Louisville",
            "state": "KY",
            "postal_code": "402194156",
            "country_code": "US",
            "telephone_number": "502-492-7455",
            "fax_number": "502-921-0222",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ANDERSON",
        "first_name": "DAVID",
        "middle_name": "MICHAEL",
        "name_suffix": "II",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2008-06-09",
        "last_updated": "2024-04-12",
        "certification_date": "2024-03-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207LP2900X",
            "taxonomy_group": "",
            "desc": "Anesthesiology, Pain Medicine",
            "state": "KY",
            "license": "46107",
            "primary": false
        },
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "KY",
            "license": "46107",
            "primary": false
        },
        {
            "code": "208VP0000X",
            "taxonomy_group": "",
            "desc": "Pain Medicine, Pain Medicine",
            "state": "KY",
            "license": "46107",
            "primary": false
        },
        {
            "code": "208VP0014X",
            "taxonomy_group": "",
            "desc": "Pain Medicine, Interventional Pain Medicine",
            "state": "IN",
            "license": "01072910A",
            "primary": false
        },
        {
            "code": "2083A0300X",
            "taxonomy_group": "",
            "desc": "Preventive Medicine, Addiction Medicine",
            "state": "KY",
            "license": "46107",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7100246110",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Annabel F Anderson, LMFT
• Ashley Anderson
• Ashley Danielle Anderson, APRN
• Brian David Anderson, D.C.
• Brit L Anderson, M.D.
• Elizabeth Anderson, PCA
• Frances Dee Anderson, ARNP, PHD
• Hannah Anderson
• Heather Anderson, FNP-C, APRN
• Heather Anderson, PHARMD

• Addiction Medicine (Preventive Medicine) Physician in Louisville, KY
• Providers in Louisville, KY by specialty
• Addiction Medicine (Preventive Medicine) Physician in Kentucky

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 12, 2024; 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.

Verify at the official NPI Registry.