CONNIE L ANDERSON (NPI# 1386651172) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1386651172 |
| Entity Type | Individual |
| Full Name | CONNIE L ANDERSON |
| Credential | PA-C |
| Practice Address |
105 N 31st Ave Ste 102 Omaha NE 68131-2940 |
| Practice Telephone | 4023461111 |
| Practice Fax Number | 4024080004 |
| Mailing Telephone | 4023461111 |
| Mailing Fax Number | 4024080004 |
| Enumeration Date | 2006-08-02 |
| Last Update Date | 2012-04-19 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363AM0700X |
Physician Assistant Specialization: Medical |
640 | NE | Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| RAILROAD MEDICARE | 970015303 | 01 | |
| NE | MIDLANDS | 810 | 01 |
| NE | BCBS | 37956 | 01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1962976613 | Connie L Anderson | Counselor | 105 Asbury Cir Ste A, Hattiesburg, MS 39402-1397 | 2019-01-16 |
| 1487701322 | Connie J Anderson | Nurse Practitioner | 2821 Ne 58th Ave, Portland, OR 97213-3473 | 2007-01-04 |
| 1396841771 | Connie Elaine Anderson | Chiropractor | 3501 S Sterling, Suite D, Independence, MO 64052 | 2006-09-15 |
| 1962485573 | Connie S. Anderson | Family Medicine | 706 Ekastown Rd, Colonial Clinic, Sarver, PA 16055-9724 | 2005-11-29 |
| 1124012919 | Connie M Anderson | Physician Assistant | 750 E Beltline Ave Ne Ste 301, Grand Rapids, MI 49525-6046 | 2005-09-07 |
| 1073619334 | Connie Anderson | Pediatrics | 1465 S Grand Blvd, Saint Louis, MO 63104-1003 | 2006-09-15 |
| Street Address |
105 N 31ST AVE STE 102 |
| City | OMAHA |
| State | NE |
| Zip Code | 68131-2940 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1649691783 | Reliable Rock | Community/Behavioral Health | 105 N 31st Ave, 212, Omaha, NE 68131-2940 | 2013-12-16 |
| 1134424096 | Shawna R Ziegler | Nurse Practitioner | 105 N 31st Ave, Omaha, NE 68131-2940 | 2011-01-24 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1821626086 | Spring Forward Ot, LLC | Occupational Therapist | 429 N. 38th Ave, Omaha, NE 68131 | 2020-03-31 |
| 1568944528 | Amy Vodicka | Case Manager/Care Coordinator | 3612 Cuming St., Omaha, NE 68131 | 2018-09-05 |
| 1982121919 | Lakeisha Marie Phelps | Peer Specialist | 3568 Dodge St, Omaha, NE 68131 | 2017-08-30 |
| 1063939098 | William L. Rolfe | Community Health Worker | 3568 Dodge Street, Suite 2, Omaha, NE 68131 | 2017-08-30 |
| 1578086294 | Nebraska Family Support Network | Community/Behavioral Health | 3568 Dodge St Ste 2, Omaha, NE 68131 | 2017-07-25 |
| 1124558937 | Beverly Hamilton | Case Manager/Care Coordinator | 3612 Cuming, Omaha, NE 68131 | 2017-06-14 |
| 1396291068 | Elizabeth George | Internal Medicine | 601 N. 30th St. Cu Department of Internal Medicine, Omaha, NE 68131 | 2016-08-31 |
| 1639625999 | Samuel Ramon Brown | Surgery | 601 N. 30th St. Cu Department of Surgery, Omaha, NE 68131 | 2016-08-28 |
| 1205289238 | Srilakshmi Reddy | Surgery | 601 N 30th St -cu Department of General Surgery, Omaha, NE 68131 | 2016-07-14 |
| 1881069409 | Jordan Sieh | Behavioral Analyst | 444 S. 44th St, Omaha, NE 68131 | 2015-12-08 |
| Find all providers in zip 68131 | ||||
| Taxonomy Code | 363AM0700X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Physician Assistant |
| Specialization | Medical |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1669745253 | Mary Maureen Garvin | Physician Assistant | Unmc Division of Endocrinology, 983020 Nebraska Medical Center, Omaha, NE 68198-3020 | 2012-02-14 |
| 1508198672 | Brian Barry Nice | Physician Assistant | 987424 Nebraska Medical Ctr, Omaha, NE 68198-7424 | 2010-02-01 |
| 1407014723 | Kylie Michelle Hutsell | Physician Assistant | 11912 Elm St Ste 26, Omaha, NE 68144-4363 | 2008-05-23 |
| 1093995342 | Jennifer Marie Moeller | Physician Assistant | 984120 Nebraska Medical Ctr, Omaha, NE 68198-4120 | 2007-11-04 |
| 1700936978 | Christina M Jensen | Physician Assistant | 7710 Mercy Rd Ste 502, Omaha, NE 68124-2346 | 2007-01-11 |
| 1104984772 | Diana R Lundquist | Physician Assistant | 7815 Farnam Dr, Children's Home Healthcare's World, Omaha, NE 68114-4564 | 2006-12-05 |
| 1528153863 | Mary Patricia Byam-smith | Physician Assistant | 1620 S 198th Ave, Omaha, NE 68130 | 2006-10-03 |
| 1194731869 | Margaret Alice Antley | Physician Assistant | 710 S 17th St, Omaha, NE 68102-3108 | 2006-08-01 |
| 1033135595 | Heartland Emergicare, P.C. | Physician Assistant | 2429 M Street, Omaha, NE 68107 | 2006-07-15 |
| 1083658892 | James Robert Meyer | Physician Assistant | 4105 Woolworth Ave, Attn: 116a4, Omaha, NE 68105-1850 | 2006-06-15 |
| Find all providers in OMAHA | ||||
Please comment or provide details below to improve the information on CONNIE L ANDERSON.
| 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.