DR. MATTHEW ROSS ANDERSON (NPI# 1073864963) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1073864963 |
| Entity Type | Individual |
| Full Name | DR. MATTHEW ROSS ANDERSON |
| Credential | D.M.D. |
| Practice Address |
1120 15th St # Gc5110 Augusta GA 30912-0004 |
| Mailing Address |
1120 15th Street Gc 5110 Augusta GA 30912 |
| Practice Telephone | (706) 721-2251 |
| Practice Fax Number | 7067230218 |
| Mailing Telephone | (706) 721-2251 |
| Mailing Fax Number | 7067230218 |
| Enumeration Date | 2012-10-02 |
| Last Update Date | 2017-08-24 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 122300000X | Dentist | 8418211-9921 | UT | Dental Providers |
| Y | 390200000X | Student in an Organized Health Care Education/Training Program | 8418211-9921 | UT | Student, Health Care |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1427665041 | Matthew Harlan Anderson | Counselor | 9233 Park Meadows Dr Ste 206, Lone Tree, CO 80124-5697 | 2020-09-28 |
| 1023645918 | Matthew Anderson | Pharmacist | Dick's Pharmacy, 526 K Shoup Ave W, Twin Falls, ID 83301 | 2020-03-23 |
| 1700257193 | Matthew Cyle Anderson | Occupational Therapist | 3160 Color Palette Ave, Henderson, NV 89044-0277 | 2015-10-12 |
| 1871911438 | Matthew Anderson | Dentist | 2565 Ne Butler Market Rd, Bend, OR 97701-1587 | 2014-04-01 |
| 1760822860 | Matthew Gordon Anderson | Social Worker | 1905b Mission 66, Vicksburg, MS 39180-3711 | 2013-07-03 |
| 1326488008 | Matthew K Anderson | Optometrist | 506 7th St W, Saint Paul, MN 55102 | 2013-06-26 |
| 1710243688 | Matthew Ron Anderson | Dentist | 90 Doctors Park, Suite B, Santa Rosa, CA 94505 | 2012-04-05 |
| 1225325061 | Matthew Paul Anderson | Occupational Therapy Assistant | 11483 Petrel Ave, Weeki Wachee, FL 34614-2730 | 2011-06-30 |
| 1538329115 | Matthew Scott Anderson | Physical Therapist | 1070 N 1st St, Cameron, WI 54822-2000 | 2008-06-17 |
| 1669659421 | Matthew Anderson | Chiropractor | 1208 S Roane St, Harriman, TN 37748-7420 | 2008-01-23 |
| Street Address |
1120 15TH ST # GC5110 |
| City | AUGUSTA |
| State | GA |
| Zip Code | 30912-0004 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1447884580 | Amir Alizadeh | Student in an Organized Health Care Education/Training Program | 1120 15th St # Gc5110, Augusta, GA 30912-0004 | 2020-02-27 |
| 1295369338 | Rachel Julia Miro | Student in an Organized Health Care Education/Training Program | 1120 15th St # Gc5110, Augusta, GA 30912-0004 | 2020-02-27 |
| 1942833595 | Phillip Brandon Gordon | Student in an Organized Health Care Education/Training Program | 1120 15th St # Gc5110, Augusta, GA 30912-0004 | 2020-02-21 |
| 1356974513 | Daniel Lucien Cassidy Jr. | Student in an Organized Health Care Education/Training Program | 1120 15th St # Gc5110, Augusta, GA 30912-0004 | 2020-02-17 |
| 1003449224 | Benjamin Rex Harrison | Student in an Organized Health Care Education/Training Program | 1120 15th St # Gc5110, Augusta, GA 30912-0004 | 2020-02-17 |
| 1144852088 | Bennett Steven Hollar | Dentist | 1120 15th St # Gc5110, Augusta, GA 30912-0004 | 2020-02-09 |
| 1447882303 | Chase Richards | Dentist | 1120 15th St # Gc5110, Augusta, GA 30912-0004 | 2020-02-09 |
| 1043842933 | Madeline Gilmer Phillips | Student in an Organized Health Care Education/Training Program | 1120 15th St # Gc5110, Augusta, GA 30912-0004 | 2020-02-07 |
| 1689132359 | Deep Patel | Dentist | 1120 15th St # Gc5110, Augusta, GA 30912-0001 | 2019-03-12 |
| 1558829796 | Alexandra Davis Harvey | Student in an Organized Health Care Education/Training Program | 1120 15th St # Gc5110, Augusta, GA 30912-0004 | 2019-03-06 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1548885940 | Hannah Gullickson Folsom | Family Medicine | 1459 Laney Walker Blvd Ae 3042, Augusta, GA 30912 | 2020-06-11 |
| 1487278909 | Robert Kennedy | Internal Medicine | Augusta University Internal Medicine Residency Program, 1120 15th Street, Bi 5070, Augusta, GA 30912 | 2020-06-01 |
| 1952968737 | Kayla M. Lasota | Pediatrics | 11230 115th St Ae3042, Augusta, GA 30912 | 2019-05-28 |
| 1003379280 | Kayla Cox | Internal Medicine | 1120 15th St Bi5070, Augusta, GA 30912 | 2019-04-13 |
| 1619435740 | Justin Ray Mackert | Student in an Organized Health Care Education/Training Program | Augusta University, 1120 15th Street, Gc 5110, Augusta, GA 30912 | 2019-03-07 |
| 1417444167 | Victor Celis | Dentist | John Wesley Gilbert Dr, Augusta, GA 30912 | 2018-04-18 |
| 1487157921 | Julie Ann Matsen | Student in an Organized Health Care Education/Training Program | 997 St. Sebastian Way, Eg-2021-10, Augusta Univ., Dept. of Psychiatry & Health Behavior, Augusta, GA 30912 | 2018-03-12 |
| 1497287031 | Luke Yuung-jier Chang | Ophthalmology | 1120 15th St # Ba2720, Augusta, GA 30912 | 2017-04-02 |
| 1821537622 | Lashawn Kay Boone | Nurse Practitioner | 1445 Harper St, Augusta, GA 30912 | 2017-02-14 |
| 1134675564 | Arnab Saha | Internal Medicine | 1120 15 Th St., Augusta, GA 30912 | 2016-08-26 |
| Find all providers in zip 30912 | ||||
| Taxonomy Code | 390200000X |
| Grouping | Student, Health Care |
| Classification | Student in an Organized Health Care Education/Training Program |
| An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care. |
| Notes: [1/1/2005: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1336764851 | Joseph Pansius | Student in an Organized Health Care Education/Training Program | 1465 Laney Walker Blvd Bldg Af-1040, Augusta, GA 30912-0002 | 2020-06-10 |
| 1093339517 | Daniel Jason Garcia | Student in an Organized Health Care Education/Training Program | 1040 Alexander Dr Apt 6323, Augusta, GA 30909-0291 | 2020-06-01 |
| 1922633643 | Miki Christine Hayashi | Student in an Organized Health Care Education/Training Program | 1120 15th Street Augusta, Augusta, GA 30912-0001 | 2020-03-03 |
| 1578195277 | Joseph Nelson Eddy | Student in an Organized Health Care Education/Training Program | 430 John Wesley Gilbert Drive, Augusta, GA 30912-0001 | 2020-02-10 |
| 1669035960 | Katherine Arenella | Student in an Organized Health Care Education/Training Program | 1 Freedom Way # 21, Augusta, GA 30904-6258 | 2019-04-22 |
| 1881257152 | Walker Barmore | Student in an Organized Health Care Education/Training Program | Augusta University 1120 15th St Bi5070, Augusta, GA 30912-0001 | 2019-04-22 |
| 1255892253 | Jennifer Bates | Student in an Organized Health Care Education/Training Program | 1120 15th St # Gc5119, Augusta, GA 30912-0004 | 2019-03-31 |
| 1861950768 | Ila Steinke | Student in an Organized Health Care Education/Training Program | S9259 County Road V, Augusta, WI 54722 | 2019-03-09 |
| 1619435740 | Justin Ray Mackert | Student in an Organized Health Care Education/Training Program | Augusta University, 1120 15th Street, Gc 5110, Augusta, GA 30912 | 2019-03-07 |
| 1609334820 | Ashley Alexandra Pater | Student in an Organized Health Care Education/Training Program | Augusta University 1120 15th Street Gc 5110, Augusta, GA 30912-0001 | 2019-03-06 |
| Find all providers in AUGUSTA | ||||
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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.