Individual provider Active NPI

Anna Wahlig, D.O.

  • Anesthesiology Physician
  • Waterloo, IL
National Provider Identifier
1245541663
Registry record updated Jun 30, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
License
2010020923 Issued in MO
Practice address
703 Lakeview Dr
Waterloo, IL 62298-1847
Phone
(573) 934-0363
NPI assigned
Jun 30, 2010
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 30, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology Physician 207L00000X 2010020923 MO Primary

Addresses

Primary practice location

703 Lakeview Dr
Waterloo, IL 62298-1847

Mailing address

703 Lakeview Dr
Waterloo, IL 62298-1847
Phone (573) 934-0363

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
I20140730001918 MO Practitioner - Anesthesiology 9830315647 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Anesthesiology
Education
Other, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Southeast Missouri Hospital Physicians LLCGroup PAC ID 9133024334, 206 clinicians

Practice addresses (Care Compare)

1701 Lacey St
Cape Girardeau, MO 63701-5230
Phone (573) 334-4822

Hospital & facility affiliations

  • Mercy Hospital Southeast Hospital, Cape Girardeau, MO, CCN 260110
  • Saint Francis Medical Center Hospital, Cape Girardeau, MO, CCN 260183

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
2010020923MOMDAnesthesiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Southeast Missouri Hospital Physicians, LLC CurrentSince Jul 1, 2014 Accepting new patients
Missouri Delta Medical Center CurrentSince Nov 1, 2024 Accepting new patients
Missouri Delta Medical Center CurrentSince Nov 1, 2024 Accepting new patients
Resource Anesthesiology Associates of Mo LLC Anesthesiology CurrentSince Dec 1, 2023 Accepting new patients

Locations

1701 Lacey St
Cpe Girardeau, MO 63701
Phone (573) 334-4822

1008 N Main St
Sikeston, MO 63801
Phone (573) 471-1600

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 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": "1277856000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1277856000000",
    "number": "1245541663",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "703 LAKEVIEW DR",
            "city": "WATERLOO",
            "state": "IL",
            "postal_code": "622981847",
            "telephone_number": "573-934-0363"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "703 LAKEVIEW DR",
            "city": "WATERLOO",
            "state": "IL",
            "postal_code": "622981847",
            "telephone_number": "573-934-0363"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WAHLIG",
        "first_name": "ANNA",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-06-30",
        "last_updated": "2010-06-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "MO",
            "license": "2010020923",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Waterloo, IL

Sources for this page

Verify at the official NPI Registry.