MARK D ANDERSON (NPI# 1073557922) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1073557922 |
| Entity Type | Individual |
| Full Name | MARK D ANDERSON |
| Credential | MD |
| Practice Address |
3801 S National Ave Springfield MO 65807-5210 |
| Mailing Address |
Po Box 9007 Springfield MO 65808-9007 |
| Practice Telephone | 4178753000 |
| Enumeration Date | 2006-06-15 |
| Last Update Date | 2018-12-27 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 207RC0000X |
Internal Medicine Specialization: Cardiovascular Disease |
36539 | MO | Allopathic & Osteopathic Physicians |
| Y | 207RI0011X |
Internal Medicine Specialization: Interventional Cardiology |
36539 | MO | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| BLUE CROSS/BLUE SHIELD | 107049 | 01 | |
| MO | 203008701 | 05 | |
| MO | 201523107 | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1326607383 | Mark Anderson | Massage Therapist | 1978 Addison Ave E, Twin Falls, ID 83301-5304 | 2019-06-12 |
| 1427403468 | Mark Anthony Anderson | Student in an Organized Health Care Education/Training Program | 157 E Rose St, Lebanon, OR 97355-4231 | 2016-04-27 |
| 1356732887 | Mark David Anderson | Licensed Practical Nurse | 227 Island Cottage Rd., Rochester, NY 14612-3627 | 2015-02-05 |
| 1134562903 | Mark William Anderson | Marriage & Family Therapist | 500 S. 580 W., Escalante, UT 84726 | 2013-04-11 |
| 1629334073 | Mark Gruen Anderson | Pharmacist | 2615 Eastern Ave, Plymouth, WI 53073-4270 | 2012-04-10 |
| 1629342928 | Mark Anderson | Social Worker | 140 Griggs Dr, Princeton, NJ 08540-7672 | 2012-03-05 |
| 1912271818 | Mark D Anderson | Licensed Practical Nurse | 4210 Wood Park Dr, Stow, OH 44224-2651 | 2012-02-24 |
| 1982905261 | Mark Alan Anderson | Pharmacist | 860 N Cleveland Ave, Loveland, CO 80537-4717 | 2010-11-03 |
| 1487822771 | Mark R Anderson | Counselor | 106 N Kenosha Dr, Madison, WI 53705-2633 | 2008-02-20 |
| 1174736953 | Mark Arthur Anderson | Specialist | 333 O'connor Dr, San Jose, CA 95128 | 2007-05-08 |
| Street Address |
3801 S NATIONAL AVE |
| City | SPRINGFIELD |
| State | MO |
| Zip Code | 65807-5210 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1144224569 | John W Clouse | Specialist | 3801 S National Ave, Springfield, MO 65807-5210 | 2005-06-13 |
| 1518568377 | Anna Marie Laffoon | Dietitian, Registered | 3801 S National Ave, Springfield, MO 65807-5210 | 2020-11-06 |
| 1164020822 | Amber Fullington | Nurse Practitioner | 3801 S National Ave, Springfield, MO 65807-5210 | 2020-10-15 |
| 1013522150 | Jessica N Rice | Nurse Practitioner | 3801 S National Ave, Springfield, MO 65807-5210 | 2020-09-15 |
| 1649880618 | Amber Littleton | Midwife | 3801 S National Ave, Springfield, MO 65807-5210 | 2020-08-05 |
| 1689283988 | Kelley Lizabeth Miller | Nurse Practitioner | 3801 S National Ave, Springfield, MO 65807-5210 | 2020-07-23 |
| 1801404140 | Alyssa Nicole Reeves | Nurse Practitioner | 3801 S National Ave, Springfield, MO 65807-5210 | 2020-07-22 |
| 1255949624 | Lori Marie Burkard | Speech-Language Pathologist | 3801 S National Ave, Springfield, MO 65807-5210 | 2020-07-21 |
| 1316555980 | Jessica Graff | Nurse Practitioner | 3801 S National Ave, Springfield, MO 65807-5210 | 2020-07-20 |
| 1033736137 | Asher Herbet | Anesthesiologist Assistant | 3801 S National Ave, Springfield, MO 65807-5210 | 2020-07-06 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1396390241 | Karley Kassandra Murphy | Counselor | 3734 South Ave #c, Springfield, MO 65807 | 2019-08-07 |
| 1396203626 | Auvia L Logan | Dietitian, Registered | 3322 S. Campbell Ave. Suite Cc, Springfield, MO 65807 | 2019-03-05 |
| 1598250961 | Kathryn Barber | Nurse Practitioner | 3800 S National Ave Ste 700, Springfield, MO 65807 | 2018-06-27 |
| 1447764899 | Missouri Midwifery Service | Clinic/Center | 3840 South Avenue, Springfield, MO 65807 | 2017-11-21 |
| 1124530290 | Senior Living Management Group, LLC | Skilled Nursing Facility | 3705 S Jefferson Ave, Springfield, MO 65807 | 2017-10-30 |
| 1740663335 | Sarah E Kirk | Physical Therapist | 3545 S. National Ave, Springfield, MO 65807 | 2015-07-01 |
| 1750713335 | Amanda Ward | Nurse Practitioner | 2150 W Republic Rd Ste 112, Springfield, MO 65807 | 2013-08-06 |
| 1932531126 | Eugenia R Cortez | Counselor | 2124 Chesterfield Blvd., Springfield, MO 65807 | 2013-07-30 |
| 1962742866 | Missouri Cvs Pharmacy LLC | Durable Medical Equipment & Medical Supplies | 3045 W Republic St, Springfield, MO 65807 | 2013-03-01 |
| 1033462387 | Miguel Angel Medina | Physician Assistant | 1900 South Sunshine Ave., Springfield, MO 65807 | 2012-10-24 |
| Find all providers in zip 65807 | ||||
| Taxonomy Code | 207RI0011X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Internal Medicine |
| Specialization | Interventional Cardiology |
| An area of medicine within the subspecialty of cardiology, which uses specialized imaging and other diagnostic techniques to evaluate blood flow and pressure in the coronary arteries and chambers of the heart and uses technical procedures and medications to treat abnormalities that impair the function of the cardiovascular system. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source] Additional Resources: American Board of Internal Medicine, 2007. http://www.abim.org/ Board Certification for Medical Doctors (MDs) is provided by the American Board of Internal Medicine. ACGME Accredited Residency Program Requirements: 1 year of training plus a prerequisite of 3 years Internal Medicine, 3 years Cardiovascular Disease for a total of 7 years. ABMS Approved Subspecialty Certificate (Internal Medicine) |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1740728039 | Jenna Schrage | Internal Medicine | 317 N 5th St, Springfield, IL 62701-1003 | 2017-02-07 |
| 1770523532 | Patrick Francis Adrian Magee | Internal Medicine | 5514 Alma Ln, Suite 200, Springfield, VA 22151-4000 | 2006-06-08 |
| 1669004966 | Effingham Hospital, Inc. | Internal Medicine | 459 Highway 119 S Ste A, Springfield, GA 31329-3021 | 2020-02-05 |
| 1023520475 | Michael Robert West | Internal Medicine | 417 Baltimore Pike, Springfield, PA 19064-3810 | 2017-10-25 |
| 1588187397 | Andrea Nicole Bloodworth | Internal Medicine | 619 E Mason St Ste 4p57, Springfield, IL 62701 | 2017-07-24 |
| 1508225616 | Margaret Jordan | Internal Medicine | 619 E Mason St, Suite 4p57, Springfield, IL 62701-1034 | 2016-02-17 |
| 1215333604 | Meredith Fleming | Internal Medicine | 619 E Mason St, Suite 4p57, Springfield, IL 62701-1034 | 2014-11-12 |
| 1326486515 | Maryna J Popp | Internal Medicine | 800 N 1st St, Springfield, IL 62702-3719 | 2013-06-10 |
| 1730425893 | Nileshkumar J Patel | Internal Medicine | 800 N 1st St, Springfield, IL 62702 | 2012-12-18 |
| 1760770101 | Bhuvnesh Aggarwal | Internal Medicine | 800 N 1st St, Springfield, IL 62702 | 2011-07-19 |
| Find all providers in SPRINGFIELD | ||||
| City | SPRINGFIELD |
| Zip Code | 65807 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.