JACK D ANDERSON (NPI# 1417976234) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1417976234 |
| Entity Type | Individual |
| Full Name | JACK D ANDERSON |
| Practice Address |
7030 Pineville Matthews Rd Charlotte NC 28226-8298 |
| Mailing Address |
Po Box 601067 Charlotte NC 28260-1067 |
| Practice Telephone | 7046674150 |
| Practice Fax Number | 7047527040 |
| Mailing Telephone | 7046674150 |
| Mailing Fax Number | 7047527040 |
| Enumeration Date | 2006-07-19 |
| Last Update Date | 2013-06-25 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 208000000X | Pediatrics | 30586 | NC | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| NC | BCBS | 11152 | 01 |
| NC | 8911152 | 05 | |
| SC | N30586 | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1982254603 | Jack Anderson | Technician | 14810 La Mesa Rd, Victorville, CA 92392-8639 | 2019-09-14 |
| 1154523470 | Jack Anderson | Chiropractor | 226 E 29th St Unit B, Loveland, CO 80538-2825 | 2007-05-31 |
| 1659338887 | Jack Anderson | Emergency Medicine | 9787 N 91st St Ste 101, Scottsdale, AZ 85258-5088 | 2006-05-01 |
| 1881166775 | Jack Raymond Anderson | Surgery | 1730 W 25th St, Cleveland, OH 44113-3108 | 2018-12-18 |
| 1245527969 | Jack D Anderson | Family Medicine | 1515 Edmonton Rd, Tompkinsville, KY 42167-9402 | 2011-07-01 |
| 1134330947 | Jack Glenn Anderson | Psychologist | 200 E Del Mar Blvd, Suite 122, Pasadena, CA 91105-2544 | 2007-05-24 |
| 1609948223 | Jack Martin Anderson | Pediatrics | 3003 Health Center Dr, San Diego, CA 92123-2700 | 2006-11-15 |
| 1992737522 | Jack Anderson | Internal Medicine | 2500 E Capitol Dr, Appleton, WI 54911-8735 | 2006-07-06 |
| 1811964000 | Jack W. Anderson | Anesthesiology | 470 Taylor Rd, Montgomery, AL 36117-3563 | 2006-03-07 |
| Street Address |
7030 PINEVILLE MATTHEWS RD |
| City | CHARLOTTE |
| State | NC |
| Zip Code | 28226-8298 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1619904430 | South Charlotte Primary Care | Family Medicine | 7030 Pineville Matthews Rd, Charlotte, NC 28226-8298 | 2006-06-27 |
| 1093263311 | Richard Truslow | Physician Assistant | 7030 Pineville Matthews Rd, Charlotte, NC 28226-8298 | 2016-09-15 |
| 1295121754 | Beth Butler | Internal Medicine | 7030 Pineville Matthews Rd, Charlotte, NC 28226-8298 | 2015-04-11 |
| 1861816134 | Mary Neal | Nurse Practitioner | 7030 Pineville Matthews Rd, Charlotte, NC 28226-8298 | 2014-02-07 |
| 1649299488 | David B Mabry | Internal Medicine | 7030 Pineville Matthews Rd, Charlotte, NC 28226-8298 | 2006-07-19 |
| 1467471292 | Lawrence Fleishman | Internal Medicine | 7030 Pineville Matthews Rd, Charlotte, NC 28226-8298 | 2006-07-19 |
| 1114946951 | Sherryl Mcphee | Internal Medicine | 7030 Pineville Matthews Rd, Charlotte, NC 28226-8298 | 2006-07-19 |
| 1760401400 | Mack White IIi | Internal Medicine | 7030 Pineville Matthews Rd, Charlotte, NC 28226-8298 | 2006-07-19 |
| 1689693418 | Kara Hamilton | Nurse Practitioner | 7030 Pineville Matthews Rd, Charlotte, NC 28226-8298 | 2006-07-19 |
| 1093740029 | Vanessa Sprague | Family Medicine | 7030 Pineville Matthews Rd, Charlotte, NC 28226-8298 | 2006-07-11 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1841837507 | Southeast Vulvar Clinic, Pllc | Dermatology | 6406 Carmel Road, Suite 309, Charlotte, NC 28226 | 2019-12-02 |
| 1427540012 | Kenneth William Riley Jr. | Behavioral Analyst | 10953 Park Rd., Charlotte, NC 28226 | 2018-05-31 |
| 1780103838 | Tamara Andres | Specialist/Technologist | 2518 Lawton Bluff Rd., Charlotte, NC 28226 | 2017-09-10 |
| 1083132609 | Xenon Anesthesia of North Carolina Pllc | Anesthesiology | 7006 Shannon Willow Road, Charlotte, NC 28226 | 2017-09-04 |
| 1104354117 | Lauren Nicole Brindisi | Chiropractor | 11230 Carmel Commons Blvd., Charlotte, NC 28226 | 2017-06-03 |
| 1346790821 | Carolinas Skin Center Pa | Plastic Surgery | 3315 Springbank Lane, Suite 202, Charlotte, NC 28226 | 2016-10-10 |
| 1871040469 | Julie R Jackson | Counselor | 7810 Prineville-mathews Road, Charlotte, NC 28226 | 2016-09-01 |
| 1518346105 | Christopher Abernathy | Dentist | 3111 Springbank Ln Ste A, Charlotte, NC 28226 | 2015-05-28 |
| 1285067504 | Amy N Bullock | Physical Therapist | 7207 Marcel Ln Apt 1138, Charlotte, NC 28226 | 2013-08-11 |
| 1528405297 | Elevate Counseling and Clinical Services, Pllc | Community/Behavioral Health | 107220 Carmel Commons Blvd., Ste. 320, Charlotte, NC 28226 | 2013-06-04 |
| Find all providers in zip 28226 | ||||
| Taxonomy Code | 208000000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Pediatrics |
| A pediatrician is concerned with the physical, emotional and social health of children from birth to young adulthood. Care encompasses a broad spectrum of health services ranging from preventive healthcare to the diagnosis and treatment of acute and chronic diseases. A pediatrician deals with biological, social and environmental influences on the developing child, and with the impact of disease and dysfunction on development. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Pediatrics, 2007. http://www.abp.org/. American Osteopathic Board of Pediatrics, 2007. http://www.osteopathic.org/certificatio - Board certification for Medical Doctors (MDs) is provided by the American Board of Pediatrics. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Pediatrics. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1619582343 | Carolinas Physicians Network Inc | Pediatrics | 9908 Couloak Dr Ste 103, Charlotte, NC 28216-8678 | 2020-09-10 |
| 1861004426 | Carolinas Physicians Network Inc | Pediatrics | 4501 Cameron Valley Pkwy Ste 200-b, Charlotte, NC 28211-4297 | 2020-08-17 |
| 1568082212 | Kidzcare Pediatrics, PC | Pediatrics | 416 Mccullough Dr Ste 140, Charlotte, NC 28262-4390 | 2020-04-23 |
| 1881222404 | Victoria Marie Carvajal | Pediatrics | Cmc/levine's Children's Hospital 1000 Blythe Blvd, 4th Floor, Meb, Charlotte, NC 28203-8812 | 2020-03-30 |
| 1386271930 | Irina Maria Geiculescu | Pediatrics | 1000 Blythe Blvd Fl 4 Meb, Charlotte, NC 28203 | 2020-03-24 |
| 1407488349 | Beth A Scisciani | Pediatrics | 8654 Walsham Dr, Charlotte, NC 28277-1850 | 2020-02-09 |
| 1962042416 | Carolinas Physicians Network Inc | Pediatrics | 1308 Scott Ave, Charlotte, NC 28204-2918 | 2020-01-13 |
| 1083175533 | Denise Makala | Pediatrics | 1000 Blythe Blvd 4th Floor, Meb, Cmc/levine Children's Hospital, Charlotte, NC 28203-5812 | 2019-03-27 |
| 1639565526 | Emily Ogletree | Pediatrics | 8401 Medical Plaza Dr Ste 220, Charlotte, NC 28262-8700 | 2015-04-08 |
| 1811392343 | Adriana Virginia Rosado-jimenez | Pediatrics | 10340 Park Rd Ste B, Charlotte, NC 28210-8401 | 2014-10-27 |
| Find all providers in CHARLOTTE | ||||
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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.