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Dr. Edward Everett Anderson , MD

Physician β€’ Durham, NC

Deactivated NPI 1063597193 Deactivated in NPPES Male Practitioner
Practice location in NPPES

508 Fulton St
Durham, NC 277053875

Phone: 9192860411

Location details and other listings
Medical Disclaimer

This profile restates public CMS/NPPES data; T-MedInfo gives no medical advice — consult a licensed professional, and call 911 for emergencies.

This NPI Is Deactivated in NPPES

NPPES lists this NPI as deactivated as of May 06, 2019; the reason is not published. The records below are historical. They do not show whether Dr. Edward Anderson currently practices or holds a license; check the state medical board for current license status.

NPI Enumeration Date October 26, 2006
NPI Deactivation Date May 06, 2019
NPI Active Period 2006 – 2019

Practice Location & Contact Primary Location

Practice Address

508 Fulton St

Durham, NC 277053875

Telephone 9192860411
Fax 9194165857
Organization at the Same NPPES Address or Phone
Durham Veterans Affairs Medical Center Facility NPI 1164481198

Matched by practice address or phone in NPPES. A shared address or phone does not confirm that this clinician works there.

NPI first issued

2006

The year this clinician's National Provider Identifier (NPI) was issued. An NPI is a unique 10-digit ID that US health care providers use for billing.

What this does not show: NPI first issued

NPIs have been issued only since 2005, so this year is not necessarily when the clinician started practicing.

Source: CMS NPPES NPI Registry.

Compared with the same specialty in Durham and North Carolina

Comparisons are not shown because NPPES lists this NPI as deactivated.

Sources: CMS Doctors and Clinicians, CMS NPPES NPI Registry. Specialty names follow the NUCC Health Care Provider Taxonomy.

Text: T-MedInfo Β· Report an error.

Specialties & License Numbers Reported to NPPES

Military Hospital Primary Specialty

NUCC Taxonomy Code: 286500000X

License # reported to NPPES NC 11426

A health care facility operated by the Department of Defense.

Check License Status with the State Board License numbers are self-reported to NPPES; T-MedInfo does not confirm them against state records. Current status: North Carolina Medical Board.
Look Up on State Board Site

Clinicians Sharing This Practice Address or Phone

Clinicians sharing this NPPES address, phone or fax; a shared contact does not mean they work together.

8 listed
NPI 1033183314

Doctor of Medicine (M.D.)

Hannah Bost , CRNA

Nurse Anesthetist, Certified Registered

NPI 1033370804

Certified Registered Nurse Anesthetist

Kelly Doyle , PMHNP-BC

Nurse Practitioner - Psychiatric/Mental Health

NPI 1013307412

Psychiatric-Mental Health Nurse Practitioner (Board Certified)

Theodore Hodges

Nurse Practitioner - Family

NPI 1053378695
Christopher Luccarelli

Psychiatry & Neurology - Psychiatry

NPI 1023696085
Dr. Michael Ward , MD

Emergency Medicine

NPI 1013151836

Doctor of Medicine (M.D.)

Career & Practice History Timeline

Changes recorded in monthly NPPES data files: addresses, names, credentials, specialties and NPI status

7 Historical Events
⚠️
NPI Profile Deactivated May 06, 2019

NPPES lists this NPI as deactivated as of May 06, 2019; the reason is not published.

βœ…
NPI Profile Active July 08, 2007

NPI status registered as active in NPPES database

πŸ“
Practice Location (Initial Record) July 08, 2007

Registered at 508 FULTON ST, DURHAM, NC 277053875 (Tel: 9192860411)

πŸ“
Business Mailing Address (Initial Record) July 08, 2007

Registered at 3808 DARWIN RD, DURHAM, NC 277075308 (Tel: 9192860411)

πŸ‘€
Provider Name / Credentials (Initial Record) July 08, 2007

Recorded as EDWARD ANDERSON, M.D.

πŸŽ“
Medical Taxonomy / Specialty Registered (Primary Specialty) July 08, 2007

Military Hospital (license number reported to NPPES: NC 11426)

🟒
Initial NPI Registration & Enumeration October 26, 2006

First registered as active Individual Practitioner in NPPES Database.

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NPI Administrative Meta

NPI Number: 1063597193
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: October 26, 2006
Last Update: July 08, 2007
Deactivation Date: May 06, 2019

Mailing Address

3808 Darwin Rd

Durham, NC 277075308

Phone: 9192860411

About This Data NPPES fields (address, phone, specialty, license) are self-reported and may be outdated; Medicare fields follow the CMS dataset named in each section. Correct directly at NPPES.