Individual provider Active NPI

Annya Lennea Moody, FNP

  • Family Nurse Practitioner
  • Saint Louis, MO
National Provider Identifier
1346516556
Registry record updated Jul 1, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
2015025650 Issued in MO
Practice address
5471 Dr Martin Luther King Dr
Saint Louis, MO 63112-4265
Phone
(314) 367-5820
Fax
(314) 367-6326
NPI assigned
Apr 2, 2012
Last updated
Jul 1, 2020By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 1, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 2015025650 MO Primary
Registered Nurse 163W00000X 2004027726 MO

Addresses

Primary practice location

5471 Dr Martin Luther King Dr
Saint Louis, MO 63112-4265

Mailing address

5471 Dr Martin Luther King Dr
Saint Louis, MO 63112-4265
Phone (314) 367-5820

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MO, IL2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20150922002364 MO Practitioner - Nurse Practitioner 7012224181 Reassigns benefits to 2 organizations
I20231213003624 IL Practitioner - Nurse Practitioner 7012224181 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
SSM Health Care St LouisGroup PAC ID 7810800737, 171 clinicians
Physicians Immediate Care North Chicago LLCGroup PAC ID 8729064159, 256 clinicians

Practice addresses (Care Compare)

12303 Depaul Dr
SSM Health Depaul Hospital Physician Billin
Bridgeton, MO 63044-2512
Phone (314) 344-6000

1711 W Hwy 50
O Fallon, IL 62269-1681
Phone (618) 206-5076

2524 N Illinois St
Swansea, IL 62226-2353
Phone (618) 212-3144

4211 N Cicero Ave
Chicago, IL 60641-1651
Phone (773) 794-1000

515 Belt Line Rd
Collinsville, IL 62234-4411
Phone (618) 381-9041

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Physicians Immediate Care North Chicago LLC CurrentSince Feb 12, 2024 Accepting new patients
SSM Health Care St Louis CurrentSince Sep 1, 2025 Accepting new patients
SSM Health Care St. Louis CurrentSince Sep 1, 2025 Accepting new patients
Signify Health, LLC CurrentSince Nov 5, 2023 Accepting new patients
Empowered Care, LLC Family Current Accepting new patients
Carestl Health Past Accepting new patients

Locations

121 W North Ave
Chicago, IL 60610
Phone (312) 643-5606

4211 N Cicero Ave
Chicago, IL 60641
Phone (773) 794-1000

7344 Solutions Ctr
Chicago, IL 60677
Phone (314) 989-6189

800 W Fulton Market
Fl 12
Chicago, IL 60607

13448 Cicero Ave
Crestwood, IL 60418
Phone (708) 682-3384

416 S Milwaukee Ave
Libertyville, IL 60048
Phone (847) 979-1112

1015 Bowles Ave
Fenton, MO 63026
Phone (636) 496-2000

2300 Main St
Fl 9
Kansas City, MO 64108
Phone (800) 416-1767

300 1st Capitol Dr
Saint Charles, MO 63301
Phone (636) 669-2211

1145 Corporate Lake Dr
Saint Louis, MO 63132
Phone (314) 989-6189

500 Marquette Ave NW
Ste 1200
Albuquerque, NM 87102
Phone (505) 295-6685

4055 Valley View Ln
Ste 400
Dallas, TX 75244
Phone (469) 466-7037

4055 Valley View Ln
Ste 700
Dallas, TX 75244
Phone (469) 466-7420

Organizations & group practices 8

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.

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": "1333324800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1593561600000",
    "number": "1346516556",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5471 DR MARTIN LUTHER KING DR",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631124265",
            "telephone_number": "314-367-5820",
            "fax_number": "314-367-6326"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5471 DR MARTIN LUTHER KING DR",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631124265",
            "telephone_number": "314-367-5820",
            "fax_number": "314-367-6326"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOODY",
        "first_name": "ANNYA",
        "middle_name": "LENNEA",
        "credential": "FNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-04-02",
        "last_updated": "2020-07-01",
        "certification_date": "2020-07-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MO",
            "license": "2015025650",
            "primary": true
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "MO",
            "license": "2004027726",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Saint Louis, MO

Sources for this page

Verify at the official NPI Registry.