Active NPI
Anasseril E Daniel, MD
- Forensic Psychiatry Physician
- Columbia, MO
National Provider Identifier
1003086638
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Forensic Psychiatry Physician
- License
- R 6029
- Practice address
- 33 E Broadway Ste 115
Columbia, MO 65203-4207 - Phone
- (573) 443-6930
- Fax
- (573) 875-4272
- NPI assigned
- Mar 11, 2008
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Forensic Psychiatry Physician | 2084F0202X | R 6029 | MO | Primary |
Addresses
Primary practice location
33 E Broadway Ste 115
Columbia, MO 65203-4207
Mailing address
33 E Broadway Ste 115
Columbia, MO 65203-4207
Phone (573) 443-6930
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| R 6029 | MO | MD | Forensic Psychiatry Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1205193600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1205193600000",
"number": "1003086638",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "33 E BROADWAY STE 115",
"city": "COLUMBIA",
"state": "MO",
"postal_code": "652034207",
"telephone_number": "573-443-6930",
"fax_number": "573-875-4272"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "33 E BROADWAY STE 115",
"city": "COLUMBIA",
"state": "MO",
"postal_code": "652034207",
"telephone_number": "573-443-6930",
"fax_number": "573-875-4272"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DANIEL",
"first_name": "ANASSERIL",
"middle_name": "E",
"name_prefix": "Dr.",
"credential": "MD",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2008-03-11",
"last_updated": "2008-03-11",
"status": "A"
},
"taxonomies": [
{
"code": "2084F0202X",
"taxonomy_group": "",
"desc": "Psychiatry & Neurology, Forensic Psychiatry",
"state": "MO",
"license": "R 6029",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Columbia, MO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 11, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.