Individual provider Active NPI

Laila Annamer

  • Student in an Organized Health Care Education/Training Program
  • Jackson, TN
National Provider Identifier
1083319628
Registry record updated Jun 21, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Student in an Organized Health Care Education/Training ProgramTaxonomy code 390200000X
License
76854 Issued in TN
Practice address
24 Physicians Dr
Jackson, TN 38305-2070
Phone
(731) 609-8738
NPI assigned
Apr 3, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 21, 2026

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X 76854 TN Primary

Addresses

Primary practice location

24 Physicians Dr
Jackson, TN 38305-2070

Mailing address

24 Physicians Dr
Jackson, TN 38305-2070
Phone (731) 609-8738

Other names 1

  • Asia Annamer Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TN
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230525003492 TN Order and Referring Only - Pediatric MedicinePractitioner - Pediatric Medicine 0042676538

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1680480000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1782000000000",
    "number": "1083319628",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "24 PHYSICIANS DR",
            "city": "JACKSON",
            "state": "TN",
            "postal_code": "383052070",
            "telephone_number": "731-609-8738"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "24 PHYSICIANS DR",
            "city": "JACKSON",
            "state": "TN",
            "postal_code": "383052070",
            "telephone_number": "731-609-8738"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ANNAMER",
        "first_name": "LAILA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-04-03",
        "last_updated": "2026-06-21",
        "certification_date": "2026-06-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "TN",
            "license": "76854",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ASIA",
            "last_name": "ANNAMER",
            "credential": "MD",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Jackson, TN

Sources for this page

Verify at the official NPI Registry.