Anna Elise Ballenger, MD

Primary specialty

Dermatology PhysicianTaxonomy code 207N00000X

License

2024024315 Issued in MO

Practice address

1 Hospital Dr # Dc043.00
Columbia, MO 65212-3748

Phone

(573) 882-1767

NPI assigned

Mar 30, 2022

Sex

Female

Sole proprietor

No

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

Specialties & licenses 4

Addresses

Other names 1

• Anna Skrade Former name

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in MO

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)

Enrolled

Credentials

Doctor of Medicine

State licenses

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

{
    "created_epoch": "1648598400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1719360000000",
    "number": "1104566199",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 HOSPITAL DR # DC043.00",
            "city": "COLUMBIA",
            "state": "MO",
            "postal_code": "652123748",
            "telephone_number": "573-882-1767"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 HOSPITAL DR # DC043.00",
            "city": "COLUMBIA",
            "state": "MO",
            "postal_code": "652123748",
            "telephone_number": "573-882-1767"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BALLENGER",
        "first_name": "ANNA",
        "middle_name": "ELISE",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-03-30",
        "last_updated": "2024-06-26",
        "certification_date": "2024-06-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MO",
            "license": "2023019866",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "MO",
            "license": null,
            "primary": false
        },
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "MO",
            "license": "2024024315",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "Aesv55@umsystem.edu",
            "affiliation": "N",
            "endpointDescription": "Email",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "807 E Green Meadows Rd Apt 303",
            "city": "Columbia",
            "state": "MO",
            "country_code": "US",
            "postal_code": "652013748",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "ANNA",
            "last_name": "SKRADE",
            "credential": "MD",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Diane Louise Baldwin, R.PH.
• Vaishnavi Balendiran, MD
• Evan Balk, MD
• Sudarshan Balla, M.D.
• John Charles Ballantyne, M.D.
• Brayton Ballenger, MD
• Alison Ballou
• Bamboo Nutrition, LLC
• Neha Bang, DO
• Abdulai Bangura, MD

• Dermatology Physician in Columbia, MO
• Providers in Columbia, MO by specialty
• Dermatology Physician in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 26, 2024; 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.