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ANDERSON MEDICAL GROUP, LLC
NPI 1700807716
General Practice in Maryville, IL

Active since July 22, 2006CLIA 14D2047041 · Waiver
6810 STATE ROUTE 162, SUITE 215, MARYVILLE, IL 62062(618) 288-5711(618) 288-4088 Get Directions Write a Review

NPPES record last updated: August 13, 2025. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Aug 13, 2025, May 19, 2025, Feb 11, 2020 (3 updates tracked since 2020).

About Anderson Medical Group, Llc NPPES

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

ANDERSON MEDICAL GROUP, LLC (NPI 1700807716) is a healthcare organization registered as a general practice in Maryville, Illinois and active in the NPI registry since July 2006. The organization holds a CLIA Waiver certificate valid through September 16, 2026 and lists Michael Marshall, Ceo, as its authorized official.

NPPES Registry Identity

NPI1700807716
Entity TypeOrganization
Primary Taxonomy208D00000X
Legal Business NameANDERSON MEDICAL GROUP, LLC
Location Address6810 STATE ROUTE 162, SUITE 215Maryville, IL 62062-8501
Mailing Address6810 State Route 162, Suite 215Maryville, IL 62062-8501 · (618) 288-5711
Phone(618) 288-5711
Fax(618) 288-4088
Organization SubpartNo
Authorized OfficialMichael MarshallCeo · (618) 391-6402
Enumeration DateJuly 22, 2006
Last NPPES UpdateAugust 13, 20253 updates tracked since enumeration
NPPES CertifiedAugust 13, 2025
✔ NPI 1700807716 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 15

★ Primary SpecialtyGeneral PracticeAllopathic & Osteopathic Physicians
Taxonomy Code208D00000X
Definition
A physician who specializes in the general practice of diagnosing, treating, and managing patients with a variety of illnesses and conditions. Source: National Uniform Claim Committee
Also ListedAnesthesiology · Pain MedicineTaxonomy 207LP2900X
Also ListedFamily MedicineTaxonomy 207Q00000X
Also ListedInternal MedicineTaxonomy 207R00000X
Also ListedInternal Medicine · Cardiovascular DiseaseTaxonomy 207RC0000X
Also ListedInternal Medicine · Critical Care MedicineTaxonomy 207RC0200X
Also ListedInternal Medicine · Endocrinology, Diabetes & MetabolismTaxonomy 207RE0101X
Also ListedInternal Medicine · GastroenterologyTaxonomy 207RG0100X
Also ListedInternal Medicine · NephrologyTaxonomy 207RN0300X
Also ListedNeurological SurgeryTaxonomy 207T00000X
Also ListedObstetrics & GynecologyTaxonomy 207V00000X
Also ListedOrthopaedic SurgeryTaxonomy 207X00000X
Also ListedOtolaryngologyTaxonomy 207Y00000X
Also ListedPsychiatry & Neurology · NeurologyTaxonomy 2084N0400X
Also ListedSurgeryTaxonomy 208600000X
6810 STATE ROUTE 162, Maryville, IL 62062
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Group Practice 1

Group TaxonomyThis provider is a business group of one or more individual practitioners, who practice with different areas of specialization.193200000X MULTI-SPECIALTY GROUP

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter from Home State Health, Ambetter Health, Ambetter Health of Delaware.Insurance ›

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 14D2047041

Anderson Medical Group · Maryville, IL
Active · expires Sep 16, 2026
CLIA Number14D2047041
Laboratory TypePhysician Office
Certificate Effective DateSeptember 17, 2024
Certificate Expiration DateSeptember 16, 2026
Laboratory DirectorBarbara Foner M D
Laboratory Phone(618) 288-6844
Laboratory LocationAnderson Medical Group6812 State Route 162 - Ste 202, Maryville, IL 62062
CLIA data matches this NPI record on: Name
This certificate is issued to a laboratory to perform only waived tests.

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.

MSA ALLIANCE, LLC DBA-SOUTHERN ILLINOIS VASCULAR AND VEIN SURGERY
Surgery (Vascular Surgery)
6810 STATE ROUTE 162, SUITE 100
MARYVILLE, IL 62062
Madison County (618) 334-2425
DR. GABRIEL CARDENAS JR. D.P.M.
Podiatrist (Foot & Ankle Surgery)
6810 STATE ROUTE 162, SUITE 20
MARYVILLE, IL 62062
Madison County (618) 288-2835
MICHAEL PETRU CRNA
Nurse Anesthetist, Certified Registered
6810 STATE ROUTE 162, SUITE 215
MARYVILLE, IL 62062
Madison County (618) 288-5711
MICHAEL SOUTHWICK CRNA
Nurse Anesthetist, Certified Registered
6810 STATE ROUTE 162, STE 215
MARYVILLE, IL 62062
Madison County (618) 288-5711
MARK FEDDER, MD, PC
Internal Medicine (Gastroenterology)
6810 STATE ROUTE 162, SUITE 211
MARYVILLE, IL 62062
Madison County (618) 288-0346
JOSEPH HINES CRNA
Nurse Anesthetist, Certified Registered
6810 STATE ROUTE 162, STE 215
MARYVILLE, IL 62062
Madison County (618) 288-5711
DR. JAMES JOSEPH DALLA RIVA M.D.
Obstetrics & Gynecology
6810 STATE ROUTE 162, SUITE 301
MARYVILLE, IL 62062
Madison County (618) 288-5699
MARK SILVEY CRNA
Nurse Anesthetist, Certified Registered
6810 STATE ROUTE 162, SUITE 215
MARYVILLE, IL 62062
Madison County (618) 288-5711

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 Anderson Medical Group, LLC's NPI number?

The NPI number for Anderson Medical Group, LLC is 1700807716. It was assigned to this organization in the NPPES registry on July 22, 2006.

Where is Anderson Medical Group, LLC located?

Anderson Medical Group, LLC is located at 6810 State Route 162 Suite 215, Maryville, IL 62062. The listed phone number is (618) 288-5711.

What is Anderson Medical Group, LLC's specialty?

The primary specialty registered for this NPI is General Practice with taxonomy code 208D00000X.

Does Anderson Medical Group, LLC hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 14D2047041) is associated with this NPI, valid through September 16, 2026. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

What insurance does Anderson Medical Group, LLC accept?

Health plans from Ambetter Health, Ambetter Health of Delaware and Ambetter from Home State Health list Anderson Medical Group, LLC as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Anderson Medical Group, LLC was last updated on August 13, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 11 months 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.