Active NPI
Anna Medical Group PA
- Family Medicine Physician
- O'Fallon, MO
National Provider Identifier
1609730886
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- 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, 2026
- Organization subpart
- No
NPPES NPI Registry
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) | Code | License | State | Primary |
|---|---|---|---|---|
| Behavior Analyst | 103K00000X | |||
| Psychologist | 103T00000X | |||
| Family Medicine Physician | 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 DirectoryLocations
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.
-
- Mental Health Counselor
- Eugene, OR
- NPI 1952714388
-
- Behavior Analyst
- Sudbury, MA
- NPI 1891310835
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.