Christy Lynn Annis, M.D.

Primary specialty

Emergency Medicine PhysicianTaxonomy code 207P00000X

License

01069919 Issued in IN

Practice address

5215 Holy Cross Pkwy
Emergency Department
Mishawaka, IN 46545-1469

Phone

(574) 335-5000

NPI assigned

Apr 17, 2007

Sex

Female

Sole proprietor

No

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Cep America LLC

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  Medicare reassignment NPD
• Elite Emergency Physicians Inc

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• Cep America LLC

  • Emergency Medicine Physician
  • Mishawaka, IN
  • NPI 1811796006

  Emergency Medicine

  NPD
• Cep America LLC

  • Emergency Medicine Physician
  • Fort Lauderdale, FL
  • NPI 1700747946

  Emergency Medicine

  NPD
• Valley Emergency Physicians Inc

  • Emergency Medicine Physician
  • Mishawaka, IN
  • NPI 1154377794

  Emergency Medicine

  NPD (past)
• Circleville Emergency Physicians Inc.

  • Emergency Medicine Physician
  • Circleville, OH
  • NPI 1770583833

  Emergency Medicine

  NPD (past)
• Emergency Medicine Physicians of Cook County LLC

  • Emergency Medicine Physician
  • Olympia Fields, IL
  • NPI 1114168929

  Emergency Medicine

  NPD (past)

Medicare fee-for-service enrollment

Enrolled in IN

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

Medicare enrollment (NPD)

Not enrolled

HHS exclusion list flag

Flagged The directory lists this NPI on an HHS exclusion list. Confirm with the OIG exclusions search.

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: cannis145044@direct.trinity-health.org

• Miss Christy Lynn Hauck Former name

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Dec 16, 2011.

{
    "created_epoch": "1176768000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1323993600000",
    "number": "1104042597",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5215 HOLY CROSS PKWY",
            "address_2": "EMERGENCY DEPARTMENT",
            "city": "MISHAWAKA",
            "state": "IN",
            "postal_code": "465451469",
            "telephone_number": "574-335-5000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5215 HOLY CROSS PKWY",
            "address_2": "EMERGENCY DEPARTMENT",
            "city": "MISHAWAKA",
            "state": "IN",
            "postal_code": "465451469",
            "telephone_number": "574-335-5000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ANNIS",
        "first_name": "CHRISTY",
        "middle_name": "LYNN",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-04-17",
        "last_updated": "2011-12-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "IL",
            "license": "036.125342",
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "OH",
            "license": "57.012518",
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "IN",
            "license": "01069919",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM",
            "identifier": "000000724321",
            "state": "IN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "201028090",
            "state": "IN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE",
            "identifier": "P00967673",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "CHRISTY",
            "last_name": "HAUCK",
            "middle_name": "LYNN",
            "prefix": "MISS",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Kiesha Anderson, D.O.
• Jessica Andreen
• Miles Burton Andrew, M.D.
• Gregory Andrianov, MD
• Hari Priya Anne, DDS
• Bilal Ansari, M.D.
• Muhammad Shahzad Mumtaz Ansari, M.D.
• Ophelia Ansari
• Rafat H Ansari, M.D.
• Apex Healthcare Group PC

• All providers in Mishawaka, IN
• Emergency Medicine Physician in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 16, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.