Healthcare Provider Details
I. General information
NPI: 1659167716
Provider Name (Legal Business Name): ANDERSON CLINIC LLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 04/16/2025
Last Update Date: 06/29/2026
Certification Date: 06/29/2026
Deactivation Date:
Reactivation Date:
III. Provider practice location address
11886 HEALING WAY STE 545
SILVER SPRING MD
20904-7917
US
IV. Provider business mailing address
2800 S SHIRLINGTON RD STE 1100
ARLINGTON VA
22206-3605
US
V. Phone/Fax
- Phone: 703-892-6500
- Fax:
- Phone: 703-769-8423
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207X00000X |
| Taxonomy | Orthopaedic Surgery Physician |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 261Q00000X |
| Taxonomy | Clinic/Center |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
BETSY
JEAN
CHAPPELL
Title or Position: CFO
Credential:
Phone: 703-892-6500