Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Ian Radford Anderson, DPT

Individual provider Physical Therapist · NPI 1447769997

Ian Radford Anderson, DPT is a Physical Therapist in Private Practice in South Lake Tahoe, California. Qualified in 2017, 9 years ago. Practices with PT Revolution Physical Therapy PC, a 12-clinician group and accepts Medicare assignment. Licensed in California and South Carolina.

Years since qualifying
9
Licensed in
CA, SC
In the registry since
2017
Specialties on file
2
What do these letters mean?
DPT — Doctor of Physical Therapy
The doctoral degree now required to enter physical therapy practice.

See every abbreviation used in this directory →

Practice location Address checks out

2038 Lake Tahoe Blvd
South Lake Tahoe, CA 96150-6499
Phone: (530) 208-9910
Fax: (530) 285-2001
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Physical Therapist (primary) Taxonomy 225100000X · Licence 295037 (CA)
Physical Therapist Taxonomy 225100000X · Licence 8708 (SC)

Record details

NPI number1447769997
Entity typeIndividual (Type 1)
GenderMale
Credentials DPT
Sole proprietorNo
NPI enumeratedSeptember 28, 2017
Last updated in NPPESJanuary 20, 2021
Certification dateJanuary 20, 2021

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyPHYSICAL THERAPIST IN PRIVATE PRACTICE
Medical schoolOTHER
Graduated 2017 (9 years in practice)
Group practice Pt Revolution Physical Therapy Pc — 12 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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