Jane Anni, MD
Individual provider Active NPI Pediatrics Physician · Malden, MO
NPI 1457741332 · NPPES record last updated Sep 9, 2020
Key facts
- NPI
- 1457741332
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Pediatrics Physician 208000000X
- License
- 36576 (MO)
- Practice address
- 806 N Douglass St
Malden, MO 63863-1512 - Phone
- (573) 276-3873
- Fax
- (573) 276-2625
- NPI assigned
- Jan 29, 2015
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 5
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in MO
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20150422001402 | MO | Practitioner - Pediatric Medicine | 9234457235 | Reassigns benefits to 2 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- No
- HHS exclusion list flag
- The National Provider Directory flags this NPI as appearing on an HHS exclusion list.
- Credentials
- Doctor of Medicine
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Poplar Bluff Regional Medical Center, LLC | Current |
Accepting new patients | |
| Poplar Bluff Regional Medical Center LLC | Current |
Accepting new patients | |
| Poplar Bluff Regional Medical Center LLC | Current | Accepting new patients | |
| Poplar Bluff Regional Medical Center, LLC | Current |
Accepting new patients | |
| Poplar Bluff Regional Medical Center LLC | Past | Accepting new patients |
Locations
806 N Douglass St
Malden, MO 63863
Phone (573) 276-3863
2360 Katy Ln
Poplar Bluff, MO 63901
Phone (573) 712-2546
130 E Harbin Ave
Puxico, MO 63960
Phone (573) 222-3556
Interoperability endpoints
- jane.anni.1@8825.direct.athenahealth.com
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatrics Physician | 208000000X | 36576 | MO | Yes |
Addresses
Primary practice location
806 N Douglass St
Malden, MO 63863-1512
Mailing address
PO Box 689022
Franklin, TN 37068-9022
Phone (888) 422-1522
Electronic endpoints
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | jane.anni.1@8825.direct.athenahealth.com |
Other providers in Malden, MO
- Advanced Sports and Rehab, LLC
- Aspire Senior Living Malden, LLC
- Anna Caitlin Batts
- Robyn Racquel Beckman
- Ray D Bess
- Miriam Brehmer
All providers in Malden, MO · Pediatrics Physician in Missouri
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Sep 9, 2020. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.