Nicholas L Anderson
Pediatrics in Neenah, WI. Individual provider (NPI-1).
NPI number1366976409
StatusActive
Last updated in NPPESJul 31, 2020
Details
- NPI
- 1366976409
- Entity type
- Individual (NPI-1)
- Name
- Mr. Nicholas L Anderson
- Sex
- Male
- Sole proprietor
- No
- Enumeration date
- Apr 15, 2017
- Certification date
- Jul 31, 2020
- Last updated
- Jul 31, 2020
Medicare and OIG
- Medicare enrolled (PECOS)
- Yes · PRACTITIONER - PEDIATRIC MEDICINE
- Can order and refer
- Part B Yes · DME Yes · Home health Yes · Power mobility Yes · Hospice Yes
- OIG exclusion list
- This NPI is not listed
CMS and OIG files of November 2026. PECOS lookup · OIG exclusion check
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 208000000X | Pediatrics | 73724-20 | WI | Yes |
Practice location
130 2nd StNeenah, WI 54956-2883
Phone 920-969-7906 · Fax 920-969-7979
Mailing address
130 2nd StNeenah, WI 54956-2883
Phone 920-969-7906 · Fax 920-969-7979
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This page shows exactly what the provider filed with NPPES. Only the provider (or their surrogate) can change it, by signing in to NPPES. Our page updates within a day of their change. See how to update NPI information.
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