Clinton M Anderson, MT, PA-C
Physician Assistant, Medical in Henderson, NV. Individual provider (NPI-1).
NPI number1740511005
StatusActive
Last updated in NPPESMar 17, 2021
Details
- NPI
- 1740511005
- Entity type
- Individual (NPI-1)
- Name
- Clinton M Anderson
- Credential
- MT, PA-C
- Sex
- Male
- Sole proprietor
- No
- Enumeration date
- Jan 26, 2010
- Certification date
- Mar 17, 2021
- Last updated
- Mar 17, 2021
Medicare and OIG
- Medicare enrolled (PECOS)
- Yes · PRACTITIONER - PHYSICIAN ASSISTANT
- Can order and refer
- Part B Yes · DME Yes · Home health Yes · Power mobility Yes · Hospice No
- 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 |
|---|---|---|---|---|
| 363AM0700X | Physician Assistant, Medical | 260790928 | NV | Yes |
Practice location
2900 W Horizon Ridge Pkwy Ste 100Henderson, NV 89052-5014
Phone 702-357-8811 · Fax 702-947-5352
Mailing address
Po Box 778413Henderson, NV 89077-8413
Phone 702-357-8811
Is something wrong?
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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