KEVIN ANDERSON (D.O.) – Family Medicine Physician, NPI 1154655157

KEVIN ANDERSON (D.O.) is a healthcare provider. based in Chickasha, Oklahoma. specializing in FAMILY PRACTICE. They hold the professional credentials D.O.. They hold a License No. 4878 (OK). The NPI Number for KEVIN ANDERSON (D.O.) is 1154655157

Main info

Male
17 Years Of Experience
Accepts Medicare Assignment
Name
KEVIN ANDERSON (D.O.)
NPI
1154655157
Phone
(405) 224-2100
Address
2100 W IOWA AVE
Enumeration Date
23 September 2009
Last Update Date
16 August 2016

Doctor Profile

Medical School Name
OTHER
Secondary Phone
4052242300
Graduation Year
2009 (17 years ago)
PAC ID
9234385386
Group Practice PAC ID
0648175778
Professional Enrollment ID
I20120806000855
Address ID
OK730182738CH2220XAVEX400
Data current as of
20 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience46
Completeness75
Years active:16State licenses:1Digital endpointsOther names

1,775 FAMILY PRACTICE in OK

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Provider Addresses for KEVIN ANDERSON (D.O.)

  • 2100, West Iowa Avenue, Chickasha, Grady County, Oklahoma, 73018, United States

    SUITE A

    CHICKASHA, OK 730182736

    Phone: (405) 224-2100

    Fax: (405) 779-2855

    Mailing address matches the actual address.

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

CMS reports 17 Open Payments records for all available years, with a total value of $300.

Total Amount is formed as General ($300) + Research ($0) + Ownership ($0) = $300.

Last reported payment date: 2024-12-13 • Largest payer in this snapshot: Abbott Laboratories ($93).

Total Amount

$300

General + Research + Ownership

Payments

17

Total payment records

General Amount

$300

General payments

Research Amount

$0

Research funding

Ownership Amount

$0

Ownership interests

Ownership Count

0

Ownership records

Last Payment Date

2024-12-13

Latest reported date

Top Companies

Largest payers in this snapshot

View all Open Payments →|Open Payments Risk Radar →

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: 2012-08-06

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

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20120806000855IFamily PracticeOKTBD

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.

Verify on CMS Revalidation Lookup Tool

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 73018)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 0648175778View full group profile
NameSpecialtyState
-OK
Family PracticeOK
Emergency MedicineOK
Emergency MedicineOK
-OK
General SurgeryTX
Family Practice, Emergency MedicineOK
Pain ManagementOK
Nurse PractitionerOK
Internal MedicineOK

Reviews

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Frequently asked questions

Can I verify KEVIN ANDERSON (D.O.) with an NPI only?
You can start verification with NPI 1154655157 for KEVIN ANDERSON (D.O.), then check state licensing separately.
Does CMS list KEVIN ANDERSON (D.O.) as active?
Yes — KEVIN ANDERSON (D.O.) is active in the NPI listing used on this page.
What is KEVIN ANDERSON (D.O.)'s specialty?
The listing groups KEVIN ANDERSON (D.O.) with Family Medicine Physician. Clinical services aligned with this taxonomy classification.
Where is KEVIN ANDERSON (D.O.) based?
KEVIN ANDERSON (D.O.) is tied to Chickasha, Oklahoma in the data we show; additional addresses may exist on the full record.
Is specialty guaranteed by NPI alone?
Taxonomy selections describe intent; scope of practice still follows state law.

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