Active NPI
Frederica Jo Nanni, MD
- Family Medicine Physician
- Christopher, IL
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- License
- 036110047
- Practice address
- 4241 Hwy 14 W
Christopher, IL 62822-0155 - Phone
- (618) 724-2401
- Fax
- (618) 724-4628
- NPI assigned
- Jun 1, 2006
- Last updated
- Nov 22, 2011
- Sex
- Female
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | 036110047 | IL | Primary |
Addresses
Primary practice location
4241 Hwy 14 W
Christopher, IL 62822-0155
Mailing address
PO Box 155
Christopher, IL 62822-0155
Phone (618) 724-2401
Other identifiers 3
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 370966854004 | Medicaid | IL | |
| CF3444 | Other | IL | MEDICARE RAILROAD GROUP |
| 036110047 | Medicaid | IL |
Other names 1
- Frederica Jo Farris
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 |
|---|---|---|---|
| 036110047 | IL | MD | Family Medicine Physician |
Practice roles
Interoperability endpoints
- https://api.platform.athenahealth.com/14668/brand/2/csg/1/fhir/r4
Organizations & group practices 19
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.
-
dba Shawnee Health Care, Carbondale Dental
- Federally Qualified Health Center (FQHC)
- Carbondale, IL
- NPI 1174859870
-
dba Shawnee Alliance
- Case Management Agency
- Carterville, IL
- NPI 1356292668
-
dba Shawnee Health Care Pharmacy
- Community/Retail Pharmacy
- Murphysboro, IL
- NPI 1043654163
-
dba Shawnee Health Care Marion OBGYN
- Federally Qualified Health Center (FQHC)
- Marion, IL
- NPI 1043902752
-
dba Shawnee Health Social Services
- Federally Qualified Health Center (FQHC)
- Carterville, IL
- NPI 1053002907
-
dba Thomas Elementary School Health Center
- Federally Qualified Health Center (FQHC)
- Carbondale, IL
- NPI 1053878967
-
dba Shawnee Health Care, Carbondale
- Federally Qualified Health Center (FQHC)
- Carbondale, IL
- NPI 1073745345
Family Medicine
-
dba Shawnee Health, Children's Dental Center - Advanced Care
- Pediatric Dentistry
- Marion, IL
- NPI 1164385753
-
dba Shawnee Health Care, Murphysboro
- Federally Qualified Health Center (FQHC)
- Murphysboro, IL
- NPI 1245260645
Family Medicine
-
dba Shawnee Health Care, Same Day
- Federally Qualified Health Center (FQHC)
- Carbondale, IL
- NPI 1285185173
Family Medicine
-
dba Terrier Care
- Federally Qualified Health Center (FQHC)
- Carbondale, IL
- NPI 1326079245
Family Medicine
-
dba Parrish Elementary School Health Center
- Federally Qualified Health Center (FQHC)
- Carbondale, IL
- NPI 1487111639
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1149120000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1321920000000",
"number": "1275570889",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 155",
"city": "CHRISTOPHER",
"state": "IL",
"postal_code": "628220155",
"telephone_number": "618-724-2401",
"fax_number": "618-724-4628"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4241 HWY 14 W",
"city": "CHRISTOPHER",
"state": "IL",
"postal_code": "628220155",
"telephone_number": "618-724-2401",
"fax_number": "618-724-4628"
}
],
"practiceLocations": [],
"basic": {
"last_name": "NANNI",
"first_name": "FREDERICA",
"middle_name": "JO",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-06-01",
"last_updated": "2011-11-22",
"status": "A"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "IL",
"license": "036110047",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "370966854004",
"state": "IL"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDICARE RAILROAD GROUP",
"identifier": "CF3444",
"state": "IL"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "036110047",
"state": "IL"
}
],
"endpoints": [],
"other_names": [
{
"first_name": "FREDERICA",
"last_name": "FARRIS",
"middle_name": "JO",
"credential": "MD",
"code": "1",
"type": "Former Name"
}
]
}Other providers in Christopher, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 22, 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.