Individual provider Active NPI

Ni Jin, M.D.

  • Anatomic Pathology & Clinical Pathology Physician
  • Hannibal, MO
National Provider Identifier
1114088549
Registry record updated Aug 15, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anatomic Pathology & Clinical Pathology PhysicianTaxonomy code 207ZP0102X
License
2014027583 Issued in MO
Practice address
6000 Hospital Dr
Hannibal, MO 63401-6887
Phone
(573) 406-5888
NPI assigned
Dec 12, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 15, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Anatomic Pathology & Clinical Pathology Physician 207ZP0102X TRN9663 FL
Anatomic Pathology & Clinical Pathology Physician 207ZP0102X 2014027583 MO Primary

Addresses

Primary practice location

6000 Hospital Dr
Hannibal, MO 63401-6887

Mailing address

6000 Hospital Dr
P O Box 551
Hannibal, MO 63401-6887
Phone (573) 248-5338

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20140918002676 MO Practitioner - Pathology 8022202993 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Pathology
Education
Other, 1982
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Hannibal Regional Healthcare System IncGroup PAC ID 1254236300, 256 clinicians

Practice addresses (Care Compare)

PO Box
Suite 1257
Hannibal, MO 63401-1257
Phone (573) 248-5460

Hospital & facility affiliations

  • Hannibal Regional Hospital Hospital, Hannibal, MO, CCN 260025
  • Blessing Hospital Hospital, Quincy, IL, CCN 140015

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
TRN9663FLMDAnatomic Pathology & Clinical Pathology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Hannibal Regional Healthcare System Inc CurrentSince Aug 20, 2014 Accepting new patients

Locations

6000 Hospital Dr
#1257
Hannibal, MO 63401
Phone (573) 248-5460

6000 Hospital Dr
Hannibal, MO 63401
Phone (573) 248-5460

Interoperability endpoints

  • FHIR API: https://fhir.fhirpoint.open.allscripts.com/fhirroute/open/10040602

Organizations & group practices 1

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 3

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": "1165881600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1723680000000",
    "number": "1114088549",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6000 HOSPITAL DR",
            "address_2": "P O BOX 551",
            "city": "HANNIBAL",
            "state": "MO",
            "postal_code": "634016887",
            "telephone_number": "573-248-5338"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6000 HOSPITAL DR",
            "city": "HANNIBAL",
            "state": "MO",
            "postal_code": "634016887",
            "telephone_number": "573-406-5888"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JIN",
        "first_name": "NI",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-12-12",
        "last_updated": "2024-08-15",
        "certification_date": "2024-08-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207ZP0102X",
            "taxonomy_group": "",
            "desc": "Pathology, Anatomic Pathology & Clinical Pathology",
            "state": "FL",
            "license": "TRN9663",
            "primary": false
        },
        {
            "code": "207ZP0102X",
            "taxonomy_group": "",
            "desc": "Pathology, Anatomic Pathology & Clinical Pathology",
            "state": "MO",
            "license": "2014027583",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hannibal, MO

Sources for this page

Verify at the official NPI Registry.