TEQUILA ANDERSON (NP) – Primary Care Nurse Practitioner, NPI 1194553826
Primary Care Nurse Practitioner
Main info
Doctor Profile
Contacts
Profile Insights
NPPES metrics only — not quality of care.
5,301 NURSE PRACTITIONER in SC
Provider Addresses for TEQUILA ANDERSON (NP)
PO BOX 530062
ATLANTA, GA 303530062
Phone: (763) 348-2075
Type: Mailing
3710 LANDMARK DR STE 408
COLUMBIA, SC 292044034
Phone: (803) 227-5320
Type: Location
1612 AIRPORT BLVD
WEST COLUMBIA, SC 291695016
Phone: (803) 380-6399
Fax: (877) 484-7187
Type: Mailing
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
CMS reports 7 Open Payments records for all available years, with a total value of $135.
Total Amount is formed as General ($135) + Research ($0) + Ownership ($0) = $135.
Last reported payment date: 2024-11-20 • Largest payer in this snapshot: AstraZeneca Pharmaceuticals LP ($31).
Total Amount
$135
General + Research + Ownership
Payments
7
Total payment records
General Amount
$135
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2024-11-20
Latest reported date
Top Companies
Largest payers in this snapshot
| Company | Amount |
|---|---|
| AstraZeneca Pharmaceuticals LP | $31 |
| Phadia US Inc. | $25 |
| Lilly USA, LLC | $24 |
| Daiichi Sankyo Inc. | $21 |
| Novo Nordisk Inc | $20 |
Medicare Enrollment & Revalidation
Source: CMS public data · Not endorsed by CMS ·
Educational use only—not medical, billing, or legal advice.
PECOS enrollment status
Participating (accepts Medicare assignment)
Enrollment effective: 2024-08-14
PECOS data refreshed: 2026-05-27
Medicare revalidation (CMS due date list)
Due date not assigned yet
CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.
Enrollment records
1
Earliest due date
Not assigned (TBD)
CMS data updated
2026-06-01
Revalidation progress
- Medicare enrolled
- On CMS revalidation list
- Due date assigned
- Revalidate in PECOS
CMS enrollment records
| Enrollment ID | Type | Specialty | State | Due date |
|---|---|---|---|---|
| I20240814001390 | I | Nurse Practitioner | SC | TBD |
What to do next
- No action required while the due date shows TBD.
- Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
- Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.
Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS
Medicare Utilization (FFS)
Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·
Educational use only—not medical, billing, or legal advice.
No Medicare fee-for-service utilization data available for this provider in our database.
Insurance plans in this area (ZIP 30353)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| Family Practice | SC | |
| Nurse Practitioner | TX | |
| Internal Medicine | GA | |
| Nurse Practitioner | GA | |
| Family Practice | SC | |
| Physician Assistant | SC | |
| Emergency Medicine, General Practice, Family Practice | SC | |
| Internal Medicine | MI | |
| Internal Medicine | SC | |
| Family Practice, General Practice | SC |
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