NPI
Kevin Ryan Anderson
This page is a copy of the public NPPES file.
Facts
- Status
- Active
- Type
- Individual
- Enumeration date
- 2019-11-19
- Last updated
- 2019-11-19
Specialties
Licenses
The registry row did not include a license.
Location
- Practice location
- 2705 E 17th St
- City
- Ammon ID
- Postal code
- 83406-6601
- Phone
- (208) 346-7500
Medicare
- PECOS
- No PECOS enrollment row matched this NPI.
LEIE
No exclusion found for this NPI in the OIG LEIE file dated October 9, 2026. OIG's online search is the official check.
Nearby
Other NPIs in Ammon, ID. 580 records in the public file.
Removal request
Public data from NPPES and CMS. Not a credentialing determination.