Deactivated NPI 1689965519 Deactivated / Inactive NPI Male Practitioner

Jerry L Anderson , CG C

Contractor - Home Modifications • Tallahassee, FL

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Notice of NPI Deactivation & Inactive Practice Status

According to official public domain records published by CMS (Centers for Medicare & Medicaid Services) in the National Provider Identifier (NPPES) Registry, Jerry Anderson has officially deactivated this NPI record and ceased active healthcare practice.

Registration / Start Date April 26, 2011

NPI Deactivation Date June 03, 2019

Total Practice Duration ~8 Years of Practice (2011 – 2019)

Professional Overview & Biography Verified Profile Summary

Jerry Anderson, CG C was a registered Contractor - Home Modifications practicing in Tallahassee, FL. Throughout an active medical career spanning 8 years, Jerry Anderson provided care at the practice location at 6493 FITZ LN until profile deactivation on 2019-06-03.

Practice Location & Contact Primary Location

Practice Address

6493 Fitz Ln

Tallahassee, FL 323119327

Telephone 8508783701

Fax 8508783701

Specialty Benchmarks & Practice Insights

Comparative analytics for Contractor - Home Modifications in Tallahassee, FL

Active Practitioner

Practitioner Clinical Experience

Active

City Avg: 10.5 Yrs

State Avg: 10.2 Yrs

Regional Practice Density

2 Specialists

Practicing in Tallahassee, FL (62 Statewide)

Telehealth Adoption Rate

0.0% Regional Adoption

In-Person Office Visits Only

Medicare Pricing Discount

67.4% Avg Savings

Under CMS Medicare Fee Schedule vs Standard Submitted Charges

Medical Specialties & State Licenses

Contractor - Home Modifications Primary Specialty

NUCC Taxonomy Code: 171WH0202X

State License FL CG-C058976

Definition to come...

Career & Practice History Timeline

Chronological log of verified NPI updates, location relocations, credentials, and registry changes

7 Historical Events

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NPI Profile Deactivated June 03, 2019

Record deactivated on June 03, 2019

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NPI Profile Active April 26, 2011

NPI status registered as active in NPPES database

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Updated Practice Location April 26, 2011

Registered at 6493 FITZ LN, TALLAHASSEE, FL 323119327 (Tel: 8508783701)

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Updated Business Mailing Address April 26, 2011

Registered at 6493 FITZ LN, TALLAHASSEE, FL 323119327 (Tel: 8508783701)

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Provider Name / Credentials Updated April 26, 2011

Recorded as JERRY ANDERSON, CG C

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Medical Taxonomy / Specialty Registered (Primary Specialty) April 26, 2011

Contractor (License #CG-C058976 in FL)

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Initial NPI Registration & Enumeration April 26, 2011

First registered as active Individual Practitioner in NPPES Database.

Patient & Community Reviews

Verified patient ratings, medical care experiences, and facility photos

0 Reviews

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NPI Administrative Meta

NPI Number: 1689965519

Entity Type:

Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)

Enumeration Date: April 26, 2011

Last Update: April 26, 2011

Deactivation Date: June 03, 2019

Update or Correct Profile

Mailing Address

6493 Fitz Ln

Tallahassee, FL 323119327

Phone: 8508783701

Public Domain Record This profile contains public domain information published by CMS and NPPES under the Freedom of Information Act (FOIA).

⚠️ Medical Disclaimer

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