Active NPI
Annya Lennea Moody, FNP
- Family Nurse Practitioner
- Saint Louis, MO
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Nurse Practitioner
- License
- 2015025650
- 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, 2020
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| 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, IL
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: No
Enrollment records 2
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
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
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Physicians Immediate Care North Chicago LLC | Current | Accepting new patients | |
| SSM Health Care St Louis | Current | Accepting new patients | |
| SSM Health Care St. Louis | Current | Accepting new patients | |
| Signify Health, LLC | Current | 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.
-
dba SSM Health St Clare Fenton
- Emergency Medicine Physician
- Fenton, MO
- NPI 1275586174
-
- Urgent Care Clinic/Center
- Chicago, IL
- NPI 1205814118
-
dba WellNow Urgent Care
- Urgent Care Clinic/Center
- Liverpool, NY
- NPI 1669825162
IL
-
dba SSM Health DePaul Hospital
- Cardiovascular Disease Physician
- Bridgeton, MO
- NPI 1376598599
-
- Federally Qualified Health Center (FQHC)
- Jennings, MO
- NPI 1912440876
Hospital & facility affiliations 1
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
dba SSM Health DePaul Hospital - St. Louis
- General Acute Care Hospital
- Bridgeton, MO
- NPI 1598835308
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
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 1, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.