Active NPI
Rennae Anderson, M.D.
- Anatomic Pathology & Clinical Pathology Physician
- Columbia, MD
National Provider Identifier
1134109341
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Anatomic Pathology & Clinical Pathology Physician
- License
- D0054375
- Practice address
- 5755 Cedar LN
Columbia, MD 21044-2912 - Phone
- (410) 940-7890
- NPI assigned
- Jan 23, 2006
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Anatomic Pathology & Clinical Pathology Physician | 207ZP0102X | D0054375 | MD | Primary |
Addresses
Primary practice location
5755 Cedar LN
Columbia, MD 21044-2912
Mailing address
PO Box 64478
Baltimore, MD 21264-4478
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 375100700 | Medicaid | MD |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| D0054375 | MD | MD | Anatomic Pathology & Clinical Pathology Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1137974400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1296259200000",
"number": "1134109341",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 64478",
"city": "BALTIMORE",
"state": "MD",
"postal_code": "212644478"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5755 CEDAR LN",
"city": "COLUMBIA",
"state": "MD",
"postal_code": "210442912",
"telephone_number": "410-940-7890"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ANDERSON",
"first_name": "RENNAE",
"credential": "M.D.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2006-01-23",
"last_updated": "2011-01-29",
"status": "A"
},
"taxonomies": [
{
"code": "207ZP0102X",
"taxonomy_group": "",
"desc": "Pathology, Anatomic Pathology & Clinical Pathology",
"state": "MD",
"license": "D0054375",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "375100700",
"state": "MD"
}
],
"endpoints": [],
"other_names": []
}Other providers in Columbia, MD
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 29, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.