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Anderson Medical Group, LLC

NPI 1700807716ActiveOrganization· General Practice· Maryville, IL

General Practice in Maryville, Illinois, registered in NPPES in July 2006. The authorized official on file is Michael Marshall, Ceo. Enrolled in Medicare as part b supplier - clinic/group practice and part b supplier - clinic/group practice.

Overview

NPI1700807716
StatusActive
Entity typeOrganization
NPI issuedJul 22, 2006
Last updated in NPPESAug 13, 2025
Certified by providerAug 13, 2025

Specialties and licenses

TaxonomyCodeLicenseState
General Practice Primary208D00000X——
Anesthesiology, Pain Medicine207LP2900X——
Family Medicine207Q00000X——
Internal Medicine207R00000X——
Internal Medicine, Cardiovascular Disease207RC0000X——
Internal Medicine, Critical Care Medicine207RC0200X——
Internal Medicine, Endocrinology, Diabetes & Metabolism207RE0101X——
Internal Medicine, Gastroenterology207RG0100X——
Internal Medicine, Nephrology207RN0300X——
Neurological Surgery207T00000X——
Obstetrics & Gynecology207V00000X——
Orthopaedic Surgery207X00000X——
Otolaryngology207Y00000X——
Psychiatry & Neurology, Neurology2084N0400X——
Surgery208600000X——

About license numbers in NPPES

Exclusion screening

ListResultDetails
HHS-OIG LEIE · Oct 9, 2026No matchChecked by NPI and by name + state
North Carolina Medicaid · Nov 10, 2026No match—
New York OMIG · Nov 10, 2026No match—
Ohio Medicaid · Nov 10, 2026No match—
Pennsylvania Medicheck · Nov 10, 2026No match—
Washington HCA · Nov 10, 2026No match—

Official OIG search · How matching works ·Bulk check a roster

Medicare

Enrollment (PECOS)Enrolled Part B Supplier - Clinic/Group Practice (AZ); Part B Supplier - Clinic/Group Practice (FL); Part B Supplier - Clinic/Group Practice (GA); Part B Supplier - Clinic/Group Practice (IL); Part B Supplier - Clinic/Group Practice (MO); Part B Supplier - Clinic/Group Practice (VA)

Medicare sources and data years

Other General Practice providers in Maryville

All General Practice providers in Illinois →