Jared Lee Anderson, APRN, FNP-C

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

AP145993 Issued in TX

Practice address

9525 N Beach St Ste 405
Fort Worth, TX 76244-6438

Phone

(817) 502-7411

NPI assigned

Jun 23, 2020

Last updated

Jun 23, 2020By 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

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in TX

Eligible to order & refer

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

Green means eligible to order or refer.

Enrollment records 1

Specialty

Nurse Practitioner

Education

Other, 2019

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Axis Brain and Back Institute PLLCGroup PAC ID 0042432015, 6 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Baylor Medical Center at Trophy Club Hospital, Trophy Club, TX, CCN 450883

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Axis Brain and Back Institute PLLC

  • Neurological Surgery Physician
  • Southlake, TX
  • NPI 1689085193
  Medicare reassignment Care Compare group NPD
• GMC Medical, PLLC

  • Surgical Physician Assistant
  • Southlake, TX
  • NPI 1073968392
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Trophy Club Medical Center LP

  dba Baylor Scott & White Medical Center - Trophy Club

  • General Acute Care Hospital
  • Trophy Club, TX
  • NPI 1982609558
  Care Compare affiliation

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

{
    "created_epoch": "1592870400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1592870400000",
    "number": "1992321251",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9525 N BEACH ST STE 405",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "762446438",
            "telephone_number": "817-502-7411"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9525 N BEACH ST STE 405",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "762446438",
            "telephone_number": "817-502-7411"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ANDERSON",
        "first_name": "JARED",
        "middle_name": "LEE",
        "credential": "APRN, FNP-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-06-23",
        "last_updated": "2020-06-23",
        "certification_date": "2020-06-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TX",
            "license": "AP145993",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPPES",
            "identifier": "1144487174",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPPES",
            "identifier": "1689085193",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Garron Anderson, PA-C
• Heather Lynn Anderson, P.T.
• James Anderson, LPC
• James E Anderson Jr., MD
• James L Anderson, C.R.N.A.
• Jesse S Anderson, BCBA
• Julianne N Anderson, PNP
• Keon Anderson, D.D.S.
• Kimberly D Anderson, LCSW
• Kimberly Diane Anderson, MS-CCC/SLP

• Family Nurse Practitioner in Fort Worth, TX
• Providers in Fort Worth, TX by specialty
• Family Nurse Practitioner in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 23, 2020; 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.