Anil Gupta M D

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

036086275 Issued in IL

Legal business name

ANIL GUPTA M D

Practice address

421 S. Main
Columbia, IL 62236

Phone

(618) 281-7151

Fax

(618) 281-6680

NPI assigned

Sep 13, 2006

Last updated

Apr 21, 2025By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Anil Gupta, M.D.NPI 1912961558

Title

Owner

Phone

(618) 281-7151

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in IL

Enrollment records 1

Locations

Practitioners 5

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.

• Anil Gupta, MD

  • Family Medicine Physician
  • Columbia, IL
  • NPI 1912961558
  Medicare reassignment NPD Authorized official
• Mallory Ann Butler, FNP

  • Family Nurse Practitioner
  • Red Bun, IL
  • NPI 1467803049
  NPD (past)
• Melinda Raye Turner, D.C.

  • Chiropractor
  • Fairview Heights, IL
  • NPI 1679888960
  NPD (past)
• Barry Ellis Breckle Jr., RN, MSN, FNP-BC

  • Family Nurse Practitioner
  • Saint Louis, MO
  • NPI 1801858121
  NPD (past)
• Ellen Rose Pace, ANP-BC

  • Adult Health Nurse Practitioner
  • Saint Louis, MO
  • NPI 1811290943
  NPD (past)

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

{
    "created_epoch": "1158105600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1745193600000",
    "number": "1699870931",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 522",
            "address_2": "421 SOUTH MAIN STREET",
            "city": "COLUMBIA",
            "state": "IL",
            "postal_code": "62236",
            "telephone_number": "618-281-7151",
            "fax_number": "618-281-6680"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "421 S. MAIN",
            "city": "COLUMBIA",
            "state": "IL",
            "postal_code": "62236",
            "telephone_number": "618-281-7151",
            "fax_number": "618-281-6680"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ANIL GUPTA M D",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-13",
        "last_updated": "2025-04-21",
        "certification_date": "2025-04-21",
        "status": "A",
        "authorized_official_last_name": "GUPTA",
        "authorized_official_first_name": "ANIL",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "618-281-7151",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "IL",
            "license": "036086275",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036086275",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Assoicated Physicians Group LTD
• Athletic and Therapeutic Institute of Bourbonnais, LLC
• Athletico LTD (Athletico Physical Therapy)
• Avc Optometry Inc
• Rebecca Badgerow-Watson, MPT,OCS

• Family Medicine Physician in Columbia, IL
• Providers in Columbia, IL by specialty
• Family Medicine Physician in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 21, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.