ANDERSON FAMILY MEDICAL CLINIC, LLC
NPI 1790398360
Clinic/Center - Health Service in Poteau, OK
About Anderson Family Medical Clinic, Llc NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
ANDERSON FAMILY MEDICAL CLINIC, LLC (NPI 1790398360) is a healthcare organization registered as a health service in Poteau, Oklahoma and active in the NPI registry since August 2020. The organization lists Shelly Dawn Anderson, Aprn, as its authorized official.
NPPES Registry Identity
Specialties & Licenses
Other Identifiers 1
Accepted Insurance
Medicare Participation & PECOS CMS
Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.
Medicare Enrollment Status
Enrolled in Medicare (PECOS)
Anderson Family Medical Clinic, Llc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Clinicians Billing Medicare Through This Organization
Medicare enrollment records show 1 clinician reassigns Medicare billing to Anderson Family Medical Clinic, LLC, which bills Medicare for the services this clinician delivers.
Clinician (1)
Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
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 Family Medical Clinic, LLC's NPI number?
The NPI number for Anderson Family Medical Clinic, LLC is 1790398360. It was assigned to this organization in the NPPES registry on August 24, 2020.
Where is Anderson Family Medical Clinic, LLC located?
Anderson Family Medical Clinic, LLC is located at 2505 N Broadway St, Poteau, OK 74953. The listed phone number is (918) 564-2726.
What is Anderson Family Medical Clinic, LLC's specialty?
The primary specialty registered for this NPI is Clinic/Center, specializing in Health Service, with taxonomy code 261QH0100X.
Is Anderson Family Medical Clinic, LLC enrolled in Medicare?
Yes. Anderson Family Medical Clinic, LLC is registered in the Medicare PECOS enrollment system.
How many clinicians bill Medicare through Anderson Family Medical Clinic, LLC?
According to the CMS Revalidation Reassignment List (October 2026 release), 1 clinician (Nurse Practitioner) reassigns their Medicare billing to Anderson Family Medical Clinic, LLC. A reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for the clinician's services. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
What insurance does Anderson Family Medical Clinic, LLC accept?
Health plans from Ambetter Health, Ambetter from Arkansas Health & Wellness, Ambetter from Sunflower Health Plan, Ambetter from Superior HealthPlan and Ambetter of Oklahoma list Anderson Family Medical Clinic, 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 Family Medical Clinic, LLC was last updated on July 17, 2022. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 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.
# Anderson Family Medical Clinic, Llc · NPI 1790398360
Health Service organization in Poteau, Oklahoma. Organization record, active in the CMS NPPES registry since August 24, 2020.
## Identity
- **NPI:** 1790398360 (Entity type: Organization)
- **Enumerated:** August 24, 2020
- **Primary specialty:** Clinic/Center - Health Service · taxonomy 261QH0100X
- **Organization subpart:** No
- **Authorized official:** Shelly Anderson, APRN
## Practice location
- **Address:** 2505 N BROADWAY ST, Poteau, OK 74953-2050
- **Phone:** (918) 564-2726 · **Fax:** (918) 564-2732
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Clinicians billing through this organization:** 1 clinician (Nurse Practitioner) reassigns Medicare billing to this organization (form CMS-855R) · CMS Revalidation Reassignment List, October 2026 release
## Record status
- **NPPES last updated:** July 17, 2022
- **Other identifiers:** Medicaid 200571200A (OK)
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Source: [NPI Profile](https://npiprofile.com/npi/1790398360) · Data from the CMS NPPES public registry.