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NATHANIEL ANDERSON MD
NPI 1205522711
Student in an Organized Health Care Education/Training Program in Charleston, WV

Active since April 17, 2023PECOS Enrolled
3100 MACCORKLE AVE SE, CHARLESTON, WV 25304(304) 388-5590(304) 388-8238 Get Directions Write a Review

NPPES record last updated: April 17, 2023. Verified against the NPPES registry weekly; last sync: August 09, 2026.

About Nathaniel Anderson Md NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

NATHANIEL ANDERSON MD (NPI 1205522711) is an individual student in an organized health care education/training program in Charleston, West Virginia and active in the NPI registry since April 2023. He is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1205522711
Entity TypeIndividualMale
Primary Taxonomy390200000X
Provider Legal NameNATHANIEL ANDERSONCredential: MD
Location Address3100 MACCORKLE AVE SECharleston, WV 25304-1223
Mailing Address3100 Maccorkle Ave SeCharleston, WV 25304-1223 · (304) 388-5590 · Fax (304) 388-8238
Phone(304) 388-5590
Fax(304) 388-8238
Sole ProprietorNo
Enumeration DateApril 17, 2023
NPPES CertifiedApril 17, 2023
✔ NPI 1205522711 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyStudent in an Organized Health Care Education/Training ProgramStudent, Health Care
Taxonomy Code390200000X
Definition
An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.
3100 MACCORKLE AVE SE, Charleston, WV 25304
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Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Nathaniel Anderson Md is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

DARSHANKUMAR ASHWINBHAI DAVE MD
Psychiatry & Neurology (Neurology)
3100 MACCORKLE AVE SE, SUITE 802
CHARLESTON, WV 25304
Kanawha County (304) 343-4400
DR. SCOTT EDWARD MILLER MD
Internal Medicine (Cardiovascular Disease)
3100 MACCORKLE AVE SE, SUITE 610
CHARLESTON, WV 25304
Kanawha County (304) 346-1141
KURT M. NELLHAUS, M.D.
Internal Medicine (Pulmonary Disease)
3100 MACCORKLE AVE SE, SUITE 806
CHARLESTON, WV 25304
Kanawha County (304) 344-9480
NANCY RABEL CANTERBURY MA
Psychologist (Clinical)
3100 MACCORKLE AVE SE, SUITE 401
CHARLESTON, WV 25304
Kanawha County (304) 346-6161
AMANDA L. NEWCOMER NP-C
Nurse Practitioner (Family)
3100 MACCORKLE AVE SE, SUITE 301
CHARLESTON, WV 25304
Kanawha County (304) 388-5395
MR. KATHLEEN A MANNION PA
Physician Assistant
3100 MACCORKLE AVE SE, SUITE 411
CHARLESTON, WV 25304
Kanawha County (304) 343-7576
JENNIFER J. HANCOCK PSY D
Psychologist (Clinical)
3100 MACCORKLE AVE SE, SUITE 101
CHARLESTON, WV 25304
Kanawha County (304) 388-8380
MRS. STACY ANNETTE CHURCH PA-C
Physician Assistant (Medical)
3100 MACCORKLE AVE SE, SUITE 610
CHARLESTON, WV 25304
Kanawha County (304) 346-1141

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Nathaniel Anderson's NPI number?

The NPI number for Nathaniel Anderson is 1205522711. It was assigned to this individual provider in the NPPES registry on April 17, 2023.

Where is Nathaniel Anderson located?

Nathaniel Anderson practices at 3100 Maccorkle Ave SE, Charleston, WV 25304. The listed phone number is (304) 388-5590.

What is Nathaniel Anderson's specialty?

The primary specialty registered for this NPI is Student in an Organized Health Care Education/Training Program with taxonomy code 390200000X.

Is Nathaniel Anderson enrolled in Medicare?

Yes. Nathaniel Anderson is registered in the Medicare PECOS enrollment system.

When was this NPI record last updated?

The NPPES record for Nathaniel Anderson was last updated on April 17, 2023. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.