Individual provider Active NPI

Anne Marie Bannister, AGNP

  • Adult Health Nurse Practitioner
  • Saint Louis, MO
National Provider Identifier
1245621093
Registry record updated Jun 12, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Health Nurse PractitionerTaxonomy code 363LA2200X
License
2015001253 Issued in MO
Practice address
4460 S Lindbergh Blvd
Saint Louis, MO 63127-1647
Phone
(314) 843-7557
NPI assigned
Feb 16, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 12, 2024

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Gerontology Nurse Practitioner 363LG0600X 2015001253 MO
Primary Care Nurse Practitioner 363LP2300X 2015001253 MO
Adult Health Nurse Practitioner 363LA2200X 2015001253 MO Primary

Addresses

Primary practice location

4460 S Lindbergh Blvd
Saint Louis, MO 63127-1647

Mailing address

4460 S Lindbergh Blvd
Saint Louis, MO 63127-1647
Phone (314) 843-7557

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20150325002480 MO Practitioner - Nurse Practitioner 8123345428 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Mercy Clinic East CommunitiesGroup PAC ID 7214827922, 573 clinicians

Practice addresses (Care Compare)

4460 S Lindbergh Blvd
Saint Louis, MO 63127-1647
Phone (314) 843-7557

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Mercy Aco Clinical Services Inc CurrentSince Mar 9, 2020 Accepting new patients

Locations

15740 South Outer 40 Rd
Chesterfield, MO 63017
Phone (636) 735-4268

1235 E Cherokee St
Springfield, MO 65804
Phone (417) 820-2115

Interoperability endpoints

  • Direct secure messaging: abannister676928@directc.mercy.net

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1424044800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1718150400000",
    "number": "1245621093",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4460 S LINDBERGH BLVD",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631271647",
            "telephone_number": "314-843-7557"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4460 S LINDBERGH BLVD",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631271647",
            "telephone_number": "314-843-7557"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BANNISTER",
        "first_name": "ANNE",
        "middle_name": "MARIE",
        "name_prefix": "Mrs.",
        "credential": "AGNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-02-16",
        "last_updated": "2024-06-12",
        "certification_date": "2024-06-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "MO",
            "license": "2015001253",
            "primary": false
        },
        {
            "code": "363LP2300X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Primary Care",
            "state": "MO",
            "license": "2015001253",
            "primary": false
        },
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "MO",
            "license": "2015001253",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Saint Louis, MO

Sources for this page

Verify at the official NPI Registry.