Individual provider Active NPI

Annie E Powers, PSYD

  • Psychologist
  • Springfield, MO
National Provider Identifier
1174529143
Registry record updated Jun 20, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
License
2005028841 Issued in MO
Practice address
3800 S National Ave Ste 770
Springfield, MO 65807
Phone
(417) 269-6891
Fax
(417) 269-5595
NPI assigned
Jun 24, 2005
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 20, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychologist 103T00000X 2005028841 MO Primary

Addresses

Primary practice location

3800 S National Ave Ste 770
Springfield, MO 65807

Mailing address

PO Box 4046
Springfield, MO 65808-4046
Phone (417) 269-5712

Other identifiers 3

IdentifierTypeStateIssuer
1174529143MedicaidMO
P00419060OtherRR MEDICARE
499182400MedicaidMO

Other names 1

  • Annie E Beatty Former name

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: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20070313000236 MO Practitioner - Clinical Psychologist 2769585785 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 2004
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Lester E Cox Medical CentersGroup PAC ID 8628092897, 243 clinicians

Practice addresses (Care Compare)

1001 E Primrose
Ferrell Duncan Clinic
Springfield, MO 65807-5155
Phone (417) 875-3000

Merit-based Incentive Payment System (MIPS)

Final score
82.25 of 100Reported as group
Quality
64.73
Promoting interoperability
100
Improvement activities
40
Cost
76.1

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2005028841MOMDPsychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Lester E Cox Medical Centers CurrentSince Oct 1, 2018 Accepting new patients

Locations

1001 E Primrose St
Springfield, MO 65807
Phone (417) 875-3434

1423 N Jefferson Ave
Springfield, MO 65802
Phone (417) 269-6583

3801 S National Ave
Springfield, MO 65807
Phone (417) 269-4056

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.

NPI Registry JSON

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

{
    "created_epoch": "1119571200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1529452800000",
    "number": "1174529143",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 4046",
            "city": "SPRINGFIELD",
            "state": "MO",
            "postal_code": "658084046",
            "telephone_number": "417-269-5712",
            "fax_number": "417-269-7567"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3800 S NATIONAL AVE STE 770",
            "city": "SPRINGFIELD",
            "state": "MO",
            "postal_code": "65807",
            "telephone_number": "417-269-6891",
            "fax_number": "417-269-5595"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "POWERS",
        "first_name": "ANNIE",
        "middle_name": "E",
        "credential": "PSYD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-06-24",
        "last_updated": "2018-06-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "MO",
            "license": "2005028841",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1174529143",
            "state": "MO"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE",
            "identifier": "P00419060",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "499182400",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ANNIE",
            "last_name": "BEATTY",
            "middle_name": "E",
            "credential": "PSYD",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Springfield, MO

Sources for this page

Verify at the official NPI Registry.