AUTUMN SAGE ANDERSON (MSN, RN, PMHNP-BC) – Psychiatric/Mental Health Nurse Practitioner, NPI 1306475413
Psychiatric/Mental Health Nurse Practitioner
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
3,532 NURSE PRACTITIONER in IA
Provider Addresses for AUTUMN SAGE ANDERSON (MSN, RN, PMHNP-BC)
3527 W COLUMBIA AVE
DAVENPORT, IA 528041123
Phone:
Type: Mailing
1441 W CENTRAL PARK AVE
DAVENPORT, IA 528041707
Phone: (563) 383-1900
Type: Location
3527 W Columbia Ave
Davenport, IA 528041123
Phone: (630) 329-4999
Type: Location
2701 17TH ST
ROCK ISLAND, IL 612015351
Phone: (309) 779-2031
Type: Mailing
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
CMS reports 2 Open Payments records for all available years, with a total value of $37.
Total Amount is formed as General ($37) + Research ($0) + Ownership ($0) = $37.
Last reported payment date: 2024-11-19 • Largest payer in this snapshot: Almatica Pharma LLC ($20).
Total Amount
$37
General + Research + Ownership
Payments
2
Total payment records
General Amount
$37
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2024-11-19
Latest reported date
Top Companies
Largest payers in this snapshot
| Company | Amount |
|---|---|
| Almatica Pharma LLC | $20 |
| E.R. Squibb & Sons, L.L.C. | $18 |
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: 2024-10-16
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 |
|---|---|---|---|---|
| I20241016004742 | I | Nurse Practitioner | IA | 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 52804)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| Clinical Social Worker | IA | |
| Nurse Practitioner | IA | |
| Clinical Social Worker | IA | |
| Nurse Practitioner | IA | |
| Nurse Practitioner | IL | |
| Nurse Practitioner | IA | |
| Clinical Social Worker | IA | |
| - | IA | |
| Clinical Social Worker | IA | |
| Mental Health Counselor | MA |
Reviews
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