Individual provider Active NPI

Anna W. Boone, ANP-BC

  • Adult Health Nurse Practitioner
  • Reidsville, NC
National Provider Identifier
1104155530
Registry record updated Aug 11, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Health Nurse PractitionerTaxonomy code 363LA2200X
License
5004551 Issued in NC
Practice address
233 Gilmer St
Reidsville, NC 27320-3809
Phone
(336) 342-6196
Fax
(336) 349-7638
NPI assigned
Dec 14, 2009
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 11, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Health Nurse Practitioner 363LA2200X 5004551 NC Primary

Addresses

Primary practice location

233 Gilmer St
Reidsville, NC 27320-3809

Mailing address

233 Gilmer Street
PO Box 2899
Reidsville, NC 27320-1069
Phone (336) 342-6196

Other identifiers 1

IdentifierTypeStateIssuer
7004530MedicaidNC

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address asams19108@direct.conehealth.com Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100113000935 NC Practitioner - Nurse Practitioner 6800937731 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Moses Cone Physician Services, IncGroup PAC ID 4284782210, 397 clinicians

Practice addresses (Care Compare)

233 Gilmer St
Reidsville, NC 27320-3809
Phone (336) 342-6196

Hospital & facility affiliations

  • Moses H. Cone Memorial Hospital, the Hospital, Greensboro, NC, CCN 340091

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
5004551NCMDAdult Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Moses Cone Physician Services, Inc. CurrentSince Sep 7, 2011 Accepting new patients
Moses Cone Physician Services Inc CurrentSince Sep 7, 2011 Accepting new patients
Moses Cone Physician Services Inc Past Accepting new patients

Locations

300 E Wendover Ave
Fl 4
Greensboro, NC 27401
Phone (336) 663-5038

301 E Wendover Ave
Ste 411
Greensboro, NC 27401
Phone (336) 832-3200

233 Gilmer St
Reidsville, NC 27320
Phone (336) 342-6196

Interoperability endpoints

  • Direct secure messaging: asams19108@direct.conehealth.com

Organizations & group practices 3

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.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1260748800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1628640000000",
    "number": "1104155530",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "233 GILMER STREET",
            "address_2": "PO BOX 2899",
            "city": "REIDSVILLE",
            "state": "NC",
            "postal_code": "273201069",
            "telephone_number": "336-342-6196",
            "fax_number": "336-349-7638"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "233 GILMER ST",
            "city": "REIDSVILLE",
            "state": "NC",
            "postal_code": "273203809",
            "telephone_number": "336-342-6196",
            "fax_number": "336-349-7638"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOONE",
        "first_name": "ANNA",
        "middle_name": "W.",
        "credential": "ANP-BC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2009-12-14",
        "last_updated": "2021-08-11",
        "certification_date": "2021-08-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "NC",
            "license": "5004551",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7004530",
            "state": "NC"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "asams19108@direct.conehealth.com",
            "affiliation": "N",
            "endpointDescription": "Cone Health Direct Address",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "233 Gilmer St",
            "city": "Reidsville",
            "state": "NC",
            "country_code": "US",
            "postal_code": "273203809",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Reidsville, NC

Sources for this page

Verify at the official NPI Registry.