Individual provider Active NPI

Anna Montague, FNP

  • Family Nurse Practitioner
  • Saint Louis, MO
National Provider Identifier
1336829035
Registry record updated Oct 23, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
2023034367 Issued in MO
Practice address
10012 Kennerly Rd Ste 406
Saint Louis, MO 63128-2197
Phone
(314) 525-1224
NPI assigned
Jul 19, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 23, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 2023034367 MO Primary

Addresses

Primary practice location

10012 Kennerly Rd Ste 406
Saint Louis, MO 63128-2197

Mailing address

10012 Kennerly Rd Ste 406
Saint Louis, MO 63128-2197
Phone (314) 525-1224

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
I20240103004508 MO Practitioner - Nurse Practitioner 1153772173 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Mercy Clinic Surgical Specialists LLCGroup PAC ID 1153455076, 180 clinicians

Practice addresses (Care Compare)

10012 Kennerly Rd
Suite 406
Saint Louis, MO 63128-2197
Phone (314) 525-1224

Hospital & facility affiliations

  • Mercy Hospital South Hospital, Saint Louis, MO, CCN 260077

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2023034367MOMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
McPherson Medical & Diagnostic, LLC Current Accepting new patients
McPherson Medical & Diagnostic, LLC CurrentSince Jan 1, 2024 Accepting new patients
McPherson Medical & Diagnostic, LLC CurrentSince Jan 1, 2024 Accepting new patients
Mercy Clinic Surgical Specialists, LLC CurrentSince Oct 21, 2024 Accepting new patients
Mercy Clinic East Communities Past Accepting new patients

Locations

16216 Baxter Rd
Ste 100
Chesterfield, MO 63017
Phone (636) 449-4700

10012 Kennerly Rd
Ste 406
Saint Louis, MO 63128
Phone (314) 525-1224

621 S New Ballas Rd
Ste 3005B
Saint Louis, MO 63141
Phone (314) 251-7070

10345 Watson Rd
Saint Louis, MO 63127
Phone (314) 384-3584

216 W Main St
Steele, MO 63877
Phone (573) 695-2181

216 W Main St
Ste B
Steele, MO 63877
Phone (573) 695-2181

851 E 5th St
Ste 108
Washington, MO 63090
Phone (636) 239-4144

Organizations & group practices 5

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 1

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": "1689724800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1729641600000",
    "number": "1336829035",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10012 KENNERLY RD STE 406",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631282197",
            "telephone_number": "314-525-1224"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10012 KENNERLY RD STE 406",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631282197",
            "telephone_number": "314-525-1224"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MONTAGUE",
        "first_name": "ANNA",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-07-19",
        "last_updated": "2024-10-23",
        "certification_date": "2024-10-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MO",
            "license": "2023034367",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Saint Louis, MO

Sources for this page

Verify at the official NPI Registry.