1285725275 NPI number — SHERIAN ANDERSON PHD

Table of content: SHERIAN ANDERSON PHD (NPI 1285725275)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1285725275 NPI number — SHERIAN ANDERSON PHD

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
ANDERSON
Provider First Name:
SHERIAN
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
PHD
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1285725275
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
02/27/2012
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 440100
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
NASHVILLE
Provider Business Mailing Address State Name:
TN
Provider Business Mailing Address Postal Code:
37244-0100
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
615-329-0570
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
250 25TH AVE N
Provider Second Line Business Practice Location Address:
STE 100
Provider Business Practice Location Address City Name:
NASHVILLE
Provider Business Practice Location Address State Name:
TN
Provider Business Practice Location Address Postal Code:
37203-1632
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
615-320-5090
Provider Business Practice Location Address Fax Number:
615-320-1225
Provider Enumeration Date:
09/27/2006

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 103TC0700X , with the licence number:  P2448 , registered in the state of TN ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 4023744 . This is a "BCBS" identifier . This identifiers is of the category "OTHER".
  • Identifier: 293199000 . This is a "MAGELLAN" identifier . This identifiers is of the category "OTHER".
  • Identifier: 293199000 . This is a "PREMIER/TN BEHAVIORAL HEA" identifier . This identifiers is of the category "OTHER".
  • Identifier: 192062 . This is a "COMPSYCH" identifier . This identifiers is of the category "OTHER".
  • Identifier: 680014969 . This is a "RR MEDICARE" identifier . This identifiers is of the category "OTHER".
  • Identifier: 107320 . This is a "UNITED HEALTHCARE" identifier . This identifiers is of the category "OTHER".




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