Individual provider Active NPI

Alicia Anderson, DVM, MPH, DIPL ACVPM

  • Military Health Care Provider
  • Atlanta, GA
National Provider Identifier
1972037323
Registry record updated Apr 12, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Military Health Care ProviderTaxonomy code 171000000X
License
05589 Issued in GA
Practice address
621 McGruder St. NE
Atlanta, GA 30312
Phone
(404) 936-2336
NPI assigned
Apr 12, 2017
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 12, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Military Health Care Provider 171000000X 05589 GA Primary

Addresses

Primary practice location

621 McGruder St. NE
Atlanta, GA 30312

Mailing address

621 McGruder St. NE
Atlanta, GA 30312

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

State licenses

LicenseStateTypeSpecialty
05589GAMDMilitary Health Care Provider

NPI Registry JSON

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

{
    "created_epoch": "1491955200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1491955200000",
    "number": "1972037323",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "621 MCGRUDER ST. NE",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "30312"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "621 MCGRUDER ST. NE",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "30312",
            "telephone_number": "404-936-2336"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ANDERSON",
        "first_name": "ALICIA",
        "name_prefix": "Dr.",
        "credential": "DVM, MPH, DIPL ACVPM",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-04-12",
        "last_updated": "2017-04-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "171000000X",
            "taxonomy_group": "",
            "desc": "Military Health Care Provider",
            "state": "GA",
            "license": "05589",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Atlanta, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 12, 2017; 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.