DR. MARCUS WALTER ANDERSON (NPI# 1801094578) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1801094578 |
| Entity Type | Individual |
| Full Name | DR. MARCUS WALTER ANDERSON |
| Credential | M.D. |
| Practice Address |
400 Health Park Blvd St Augustine FL 32086-5784 |
| Practice Telephone | 9048194565 |
| Practice Fax Number | 9048194999 |
| Mailing Telephone | 9048194040 |
| Mailing Fax Number | 9048194041 |
| Enumeration Date | 2007-07-04 |
| Last Update Date | 2013-02-12 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2084F0202X |
Psychiatry & Neurology Specialization: Forensic Psychiatry |
ME105840 | FL | Allopathic & Osteopathic Physicians |
| N | 2084P0800X |
Psychiatry & Neurology Specialization: Psychiatry |
TRN10998 | FL | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| FL | BCBS | 14N4N | 01 |
| FL | 116379300 | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1467793802 | Marcus Wendell Anderson | Dental Hygienist | 25360 Shiawassee Cir Apt 203, Southfield, MI 48033-3861 | 2013-03-11 |
| 1760914105 | Marcus Anderson | Speech-Language Pathologist | 6128 E 38th St Ste 400, Tulsa, OK 74135-5808 | 2017-04-03 |
| 1598206625 | Marcus Anderson | Physical Therapist | 11169 W Colonial Dr, Ocoee, FL 34761-2935 | 2017-03-08 |
| 1285879007 | Marcus Maurice Anderson | Counselor | 620 S Laurel St, Pine Bluff, AR 71601-4859 | 2008-12-08 |
| 1316107618 | Marcus Ray Anderson | Radiology | 16750 Red Oak Dr, Houston, TX 77090-2543 | 2008-06-11 |
| Street Address |
400 HEALTH PARK BLVD |
| City | ST AUGUSTINE |
| State | FL |
| Zip Code | 32086-5784 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1801881818 | Emergency Physicians of St. Johns County | Emergency Medicine | 400 Health Park Blvd, St Augustine, FL 32086-5784 | 2005-09-15 |
| 1245846468 | Nicole Marie Zisman | Internal Medicine | 400 Health Park Blvd, St Augustine, FL 32086-5784 | 2020-09-22 |
| 1700499522 | Yolanda Campbell | Family Medicine | 400 Health Park Blvd, St Augustine, FL 32086-5784 | 2020-08-31 |
| 1952912826 | Megan Burke | Physician Assistant | 400 Health Park Blvd, St Augustine, FL 32086-5790 | 2020-08-13 |
| 1639709173 | Keith Latasiewicz | Nurse Anesthetist, Certified Registered | 400 Health Park Blvd, St Augustine, FL 32086-5784 | 2020-01-23 |
| 1508416991 | Ashley Jarriel Gucwa | Physician Assistant | 400 Health Park Blvd, St Augustine, FL 32086-5784 | 2019-09-17 |
| 1831741925 | Jessica Anne Lindamood | Dietitian, Registered | 400 Health Park Blvd, St Augustine, FL 32086-5790 | 2019-07-10 |
| 1649787326 | Spencer Jonathan Garrison | Nurse Anesthetist, Certified Registered | 400 Health Park Blvd, St Augustine, FL 32086-5784 | 2018-01-04 |
| 1750804662 | Gabrielle Du Sablon | Physician Assistant | 400 Health Park Blvd, St Augustine, FL 32086-5784 | 2017-07-23 |
| 1124540588 | Jessica Marie Johnson | Physician Assistant | 400 Health Park Blvd, St Augustine, FL 32086-5784 | 2017-07-07 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1225670037 | Ramonica Flagler | Nurse Practitioner | 3574 Us-1 South, St. Augustine, FL 32086 | 2019-10-14 |
| 1518522648 | Marissa Marie Lynch | Physician Assistant | 100 Whetstone Pl Ste 102, St Augustine, FL 32086 | 2019-05-03 |
| 1346706991 | Castillo Transportation | Non-emergency Medical Transport (VAN) | 295 North Hidden Tree Dr, Saint Augustine, FL 32086 | 2019-02-19 |
| 1790255842 | Michelle Moore | In Home Supportive Care | 135 Jenkins St. Suite 105b #265, St.augustine, FL 32086 | 2018-12-03 |
| 1649740200 | Paul James Lietz IIi | Physical Therapist | One Orthopedic Place, Saint Augustine, FL 32086 | 2018-11-27 |
| 1548764707 | Oceanside Endodontics Od St. Augustine | Dentist | 2510 U.S. 1 South, Suite B, St. Augustine, FL 32086 | 2018-03-22 |
| 1023538329 | Joseph R Edwards | Physical Therapist | 968 Espinado Avenue, St Augustine, FL 32086 | 2017-06-27 |
| 1235662032 | Jennifer L Csenge | Dentist | 4327 Us Highway 1 S, St Augustine, FL 32086 | 2017-04-07 |
| 1336683663 | Lisa Brice | Social Worker | 248 Southpark Circle East, Saint Augustine, FL 32086 | 2016-12-06 |
| 1558813303 | Bio-medical Applications of Florida, Inc. | Clinic/Center | 65 Whitehall Drive, Saint Augustine, FL 32086 | 2016-10-27 |
| Find all providers in zip 32086 | ||||
| Taxonomy Code | 2084F0202X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Psychiatry & Neurology |
| Specialization | Forensic Psychiatry |
| Forensic Psychiatry is a subspecialty with psychiatric focus on interrelationships with civil, criminal and administrative law, evaluation and specialized treatment of individuals involved with the legal system, incarcerated in jails, prisons, and forensic psychiatry hospitals. |
| Notes: Source: The American Board of Psychiatry and Neurology, Inc. www.abpn.com [1/1/2007: new definition] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1487000816 | Barbara Stein | Psychiatry & Neurology | 200 2nd Ave S # 169, St Petersburg, FL 33701-4313 | 2016-05-04 |
| 1205278454 | Medical & Psychiatric Insitiute of Florida, Inc. | Psychiatry & Neurology | 6056 Central Park Blvd, Port Orange, FL 32127-9539 | 2013-07-29 |
| 1518233451 | H. Barry Miller, M.d., P.a. | Psychiatry & Neurology | 3363 Sheridan Street, Suite #210, Hollywood, FL 33021-3658 | 2012-03-26 |
| 1922328228 | Jacqueline E Barrett Md, Pa | Psychiatry & Neurology | 4651 Sheridan St Ste 450, Hollywood, FL 33021-3415 | 2010-06-09 |
| 1144548611 | Family & Forensic Psychiatry | Psychiatry & Neurology | 4965 Sw 91st Ter Ste A, Gainesville, FL 32608-8155 | 2010-05-09 |
| 1629200647 | Asad Hamid Khan | Psychiatry & Neurology | 927 Beville Rd, Suite # 7, South Daytona, FL 32119-1768 | 2009-08-10 |
| 1619160298 | Alan J. Waldman | Psychiatry & Neurology | 2727 Nw 43rd Street, Gainesville, FL 32606 | 2007-08-27 |
| 1497948996 | Ronald M Chase | Psychiatry & Neurology | 32910 Lakeshore Dr, Tavares, FL 32778-5013 | 2007-08-20 |
| 1568668168 | Jacqueline Elaine Barrett | Psychiatry & Neurology | 816 Nw Avenue D, Belle Glade, FL 33430-2904 | 2007-06-21 |
| 1366657694 | David Grippe | Psychiatry & Neurology | 2733 Mount Pleasant Rd, Quincy, FL 32352-6684 | 2007-05-11 |
| Find all providers with the same taxonomy | ||||
| City | ST AUGUSTINE |
| Zip Code | 32086 |
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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.