NPIMap

Individual provider Active NPI

Anne E. Petersen, M.D.

  • Surgery Physician
  • Columbia, MO
National Provider Identifier
1114968435
Registry record updated Feb 13, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
License
2006010643 Issued in MO
Practice address
1601 E Broadway
Ste 240
Columbia, MO 65201-8020
Phone
(573) 815-8145
Fax
(573) 815-3832
NPI assigned
Jun 9, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 13, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X 2006010643 MO Primary

Addresses

Primary practice location

1601 E Broadway
Ste 240
Columbia, MO 65201-8020

Mailing address

670 Mason Ridge Center Dr
Ste 300
Saint Louis, MO 63141-8573
Phone (573) 815-8145

Other identifiers 5

IdentifierTypeStateIssuer
P00344374OtherMORAILROAD MEDICARE
201431509MedicaidMO
CD6061OtherMORAILROAD GROUP
767347OtherMOHEALTHLINK
210746OtherMOBCBS

Other names 1

  • Anne E. Dabney Other name

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20060823000286 MO Practitioner - General Surgery 5799788261 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
General Surgery
Education
Saint Louis University School of Medicine, 2001
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Boone Physician Services LLCGroup PAC ID 6507090644, 243 clinicians

Practice addresses (Care Compare)

1601 E Broadway
Suite 240
Columbia, MO 65201-8022
Phone (573) 815-8145

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Colonoscopy1-10
Hernia repair - groin (open)1-10
Mastectomy44
Melanoma (skin cancer) excision11
Removal of tissue1-10
Skin biopsy1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
2006010643MOMDSurgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
General John J Pershing Memorial Hospital Association CurrentSince Feb 16, 2026 Accepting new patients
Boone Physician Services, LLC CurrentSince Jan 1, 2020 Accepting new patients
General John J Pershing Memorial Hospital Association CurrentSince Feb 16, 2026 Accepting new patients
Jefferson City Medical Group, P.C. Past Accepting new patients

Locations

130 E Lockling St
Brookfield, MO 64628
Phone (660) 258-1050

1601 E Broadway
Ste 240
Columbia, MO 65201
Phone (573) 815-8145

1701 E Broadway
Ste 302
Columbia, MO 65201
Phone (573) 815-7146

1600 E Broadway
Columbia, MO 65201
Phone (573) 632-5000

1705 E Broadway
Ste 280
Columbia, MO 65201
Phone (573) 815-7119

Interoperability endpoints

  • Direct secure messaging: annepetersen@mhccaremail.com

Organizations & group practices 4

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 16

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

View all 16

NPI Registry JSON

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

{
    "created_epoch": "1149811200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1486944000000",
    "number": "1114968435",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "670 MASON RIDGE CENTER DR",
            "address_2": "STE 300",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631418573",
            "telephone_number": "573-815-8145",
            "fax_number": "573-815-3832"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1601 E BROADWAY",
            "address_2": "STE 240",
            "city": "COLUMBIA",
            "state": "MO",
            "postal_code": "652018020",
            "telephone_number": "573-815-8145",
            "fax_number": "573-815-3832"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PETERSEN",
        "first_name": "ANNE",
        "middle_name": "E.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-06-09",
        "last_updated": "2017-02-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "MO",
            "license": "2006010643",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "P00344374",
            "state": "MO"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "201431509",
            "state": "MO"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD GROUP",
            "identifier": "CD6061",
            "state": "MO"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTHLINK",
            "identifier": "767347",
            "state": "MO"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "210746",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ANNE",
            "last_name": "DABNEY",
            "middle_name": "E.",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Columbia, MO

Sources for this page

Verify at the official NPI Registry.