Organization Active NPI

Anna Medical Group PA

  • Family Medicine Physician
  • O'Fallon, MO
National Provider Identifier
1609730886
Registry record updated Jul 15, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
ANNA MEDICAL GROUP PA
Practice address
1120 Technology Dr Ste 113B
O Fallon, MO 63368-2201
Phone
(617) 693-5767
Fax
(866) 450-0941
NPI assigned
Dec 12, 2025
Last updated
Jul 15, 2026By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 15, 2026

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

Authorized official

Name
Shayna Walker, MD
Title
Owner
Phone
(617) 693-5767

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Behavior AnalystGroup: 193200000X MULTI-SPECIALTY GROUP 103K00000X
PsychologistGroup: 193200000X MULTI-SPECIALTY GROUP 103T00000X
Family Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207Q00000X Primary

Addresses

Primary practice location

1120 Technology Dr Ste 113B
O Fallon, MO 63368-2201

Mailing address

19266 Coastal Hwy Unit 41112
Rehoboth Beach, DE 19971-6117
Phone (617) 693-5767

Other practice location 1

490 Boston Post Rd Ste 1A
Sudbury, MA 01776-3367
Phone (617) 693-5767

National Provider Directory

National Provider Directory

Locations

19266 Coastal Hwy
Unit 41112
Rehoboth Beach, DE 19971

1120 Technology Dr
Ste 113B
O Fallon, MO 63368
Phone (617) 693-5767

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1765497600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1784073600000",
    "number": "1609730886",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "19266 COASTAL HWY UNIT 41112",
            "city": "REHOBOTH BEACH",
            "state": "DE",
            "postal_code": "199716117",
            "telephone_number": "617-693-5767",
            "fax_number": "866-450-0941"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1120 TECHNOLOGY DR STE 113B",
            "city": "O FALLON",
            "state": "MO",
            "postal_code": "633682201",
            "telephone_number": "617-693-5767",
            "fax_number": "866-450-0941"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "490 Boston Post Rd Ste 1A",
            "address_purpose": "LOCATION",
            "city": "Sudbury",
            "state": "MA",
            "postal_code": "017763367",
            "country_code": "US",
            "telephone_number": "617-693-5767",
            "fax_number": "866-450-0941",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "ANNA MEDICAL GROUP PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-12-12",
        "last_updated": "2026-07-15",
        "certification_date": "2026-07-15",
        "status": "A",
        "authorized_official_last_name": "WALKER",
        "authorized_official_first_name": "SHAYNA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "617-693-5767",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Behavior Analyst",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "103T00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychologist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in O'Fallon, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 15, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.