Rocky Anderson, DDS

Primary specialty

DentistTaxonomy code 122300000X

License

12012324A Issued in IN

Practice address

4570 W Jonathan Moore Pike
Columbus, IN 47201-4686

Phone

(812) 342-3969

NPI assigned

Jun 9, 2015

Last updated

Aug 1, 2019By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Enrolled in IN

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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.

• Dental Professionals of Indiana, P.C.

  dba Prestwick Pointe Family Dental Care

  • General Practice Dentistry
  • Avon, IN
  • NPI 1376765503
  NPD (past)

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

{
    "created_epoch": "1433808000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1564617600000",
    "number": "1982085536",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5250 E US HIGHWAY 36 STE 160",
            "city": "AVON",
            "state": "IN",
            "postal_code": "461239078",
            "telephone_number": "317-745-1680",
            "fax_number": "317-745-1119"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4570 W JONATHAN MOORE PIKE",
            "city": "COLUMBUS",
            "state": "IN",
            "postal_code": "472014686",
            "telephone_number": "812-342-3969"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ANDERSON",
        "first_name": "ROCKY",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-06-09",
        "last_updated": "2019-08-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "IN",
            "license": "12012324A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Anderson Therapy Group Speech LLC
• Holly Grace Anderson
• Kayla Anderson, RBT
• Kelly Marie Anderson, APRN
• Rebecca Anderson, RBT
• Cinda Andis, RN
• Samantha Leigh Andros, MSW, LSW
• Annabelle Andrus
• Brittany Laine Andrus, PMHNP
• Angie Nielsen LLC

• Dentist in Columbus, IN
• Providers in Columbus, IN by specialty
• Dentist in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 1, 2019; 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.