Trevor Ryan Anderson
Physical Medicine & Rehabilitation Doctor Pain Medicine
1136 Jackson Blvd Ste 3
Rapid City
, South Dakota 57702-4397
Trevor Ryan Anderson
Physical Medicine & Rehabilitation Doctor Pain Medicine
1136 Jackson Blvd Ste 3
Rapid City
, South Dakota 57702-4397
(605) 341-4501
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About
Features
Specialties
- Physical Medicine & Rehabilitation Doctor
- Pain Medicine
Languages spoken
- English
Location
First Address
- Trevor Ryan Anderson
- 1136 Jackson Blvd Ste 3
- Rapid City, SD
- Zip : 57702-4397
- Fax : (605) 341-4501
- Phone : (605) 721-7246
Second Address
- Trevor Ryan Anderson
- 1136 Jackson Blvd Ste 3
- Rapid City, SD
- Zip : 57702-4397
- Fax : (605) 341-4501
- Phone : (605) 721-7246
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FAQs
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Scope of Practice
| Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
|---|---|---|---|---|
| Y | 208100000X | Physical Medicine & Rehabilitation Doctor | 8543 | SD |
| N | 2081P2900X | Pain Medicine | 8543 | SD |
National Provider Identifier
| NPI | 1386838324 |
|---|---|
| Provider Name | Trevor Ryan Anderson |
| First Address | Rapid City, SD 57702-4397 |
| Second Address | Rapid City, SD 57702-4397 |
| Gender | M |
| NPI Entity type | Individual |
| Is Sole Proprietor | No |
| Is Organization Subpart | N/A |
| Enumeration Date | 04/09/2007 |
| Last Update Date | 03/07/2013 |
Additional Identifiers
| IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
|---|---|---|
| 0023-0001076 | MEDICA (01) | SD |
| 0300406 | ST OF WASH, DEPT OF LABOR (01) | SD |
| 1386838324 | (05) | SD |
| 1386838324 | FIRST CHOICE OF THE MIDWEST (01) | SD |
| 1386838324 | RR MEDICARE (01) | SD |
| 1386838324 | TLC ADVANTAGE (01) | SD |
| 41194500700 | NEBRASKA MEDICAID (01) | SD |
| P01112476 | RR MEDICARE PTAN (01) | SD |
NPI Footnotes
What is the National Provider Identifier (NPI)
Provider Location Address
Provider Mailing Address
Entity Type Code
1= Person: individual human being who furnishes health care;
2= Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)
What is a Subpart?
Provider Other Organization Name
1 = former name;
2 = professional name;
3 = doinq business as (d/b/ a) name;
4 = former legal business name;
5 = other.