MEDICARE: JASON ANDERSON DPM

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	213E00000X	Podiatrist	000868	IA
2	213ES0103X	Foot & Ankle Surgery Podiatrist	216	SD
3	213E00000X	Podiatrist	216	SD
4	213ES0103X	Foot & Ankle Surgery Podiatrist	2021033439	MO
5	213ES0103X	Foot & Ankle Surgery Podiatrist	12-00473	KS
6	213E00000X	Podiatrist	337	NE
7	213E00000X	Podiatrist	12-00473	KS

General Provider Information

NPI Number	:	1588821979
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JASON ANDERSON DPM

Provider Business Mailing Address
First Line	:	1010 CARONDELET DR STE 301
Second Line	:
City	:	KANSAS CITY
State	:	MO
Zip	:	64114-4823
Country	:	US
Telephone Number	:	816-943-1111
Fax Number	:	913-780-4834

Provider Business Practice Location Address
First Line	:	1010 CARONDELET DR STE 301
Second Line	:
City	:	KANSAS CITY
State	:	MO
Zip	:	64114-4823
Country	:	US
Telephone Number	:	816-943-1111
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/22/2008
Last Update Date	:	10/20/2025

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Directions to “ JASON ANDERSON DPM” Practice Location

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