Ann Allisa Church, MD

Primary specialty

Dermatopathology PhysicianTaxonomy code 207ND0900X

License

ME97605 Issued in FL

Practice address

132 Dundee PL
St Johns, FL 32259-8223

Phone

(800) 330-6770

Fax

(954) 633-3217

NPI assigned

Nov 6, 2006

Last updated

Jan 29, 2024By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other names 1

• Ann Allisa Bauernfiend Former name

Medicare fee-for-service enrollment

Enrolled in FL

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

Practice roles

Locations

Networks

• Optimum HealthCare HMO Network
• Freedom Health HMO Network

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Bernhardt Laboratories Inc

  • Anatomic Pathology & Clinical Pathology Physician
  • Jacksonville, FL
  • NPI 1235893405
  Medicare reassignment NPD
• Ameripath Florida LLC

  • Clinical Medical Laboratory
  • Saint Johns, FL
  • NPI 1699468298
  NPD
• Ameripath Florida LLC

  • Clinical Medical Laboratory
  • Tampa, FL
  • NPI 1962254987
  NPD (past)
• Bernhardt Laboratories Inc

  • Clinical Medical Laboratory
  • Jacksonville, FL
  • NPI 1417960626
  NPD (past)

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

{
    "created_epoch": "1162771200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1706486400000",
    "number": "1205905486",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14275 MIDWAY RD STE 400",
            "city": "ADDISON",
            "state": "TX",
            "postal_code": "750013661",
            "telephone_number": "866-697-8378",
            "fax_number": "610-271-4245"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "132 DUNDEE PL",
            "city": "ST JOHNS",
            "state": "FL",
            "postal_code": "322598223",
            "telephone_number": "800-330-6770",
            "fax_number": "954-633-3217"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHURCH",
        "first_name": "ANN",
        "middle_name": "ALLISA",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-11-06",
        "last_updated": "2024-01-29",
        "certification_date": "2024-01-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "FL",
            "license": "ME97605",
            "primary": false
        },
        {
            "code": "207ND0900X",
            "taxonomy_group": "",
            "desc": "Dermatology, Dermatopathology",
            "state": "FL",
            "license": "ME97605",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ANN",
            "last_name": "BAUERNFIEND",
            "middle_name": "ALLISA",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Colin Robert Chaloupecky, MD
• Arianne E Chavez, MD
• Caitlyn Ashley Nicole Chesser, CLC
• Joseph Gerard Chiafair, DDS
• Children's Express Care Clinic (Excel Pediatrics)
• Eiryn Cintron-Baerga, PA-C
• Makayla N Clemons
• Coastal Clear Eyecare
• Kimberly Ann Coggins, PA-C
• Daniel Collins

• Dermatopathology Physician in Saint Johns, FL
• Providers in Saint Johns, FL by specialty
• Dermatopathology Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 29, 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.