Individual provider Active NPI

Janna R Crosnoe, M.D.

  • Family Medicine Physician
  • Cape Girardeau, MO
National Provider Identifier
1720017296
Registry record updated Aug 5, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
106393 Issued in MO
Practice address
408 S Broadview St
Cape Girardeau, MO 63703-5725
Phone
(573) 332-0808
NPI assigned
Jun 30, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 5, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 106393 MO Primary

Addresses

Primary practice location

408 S Broadview St
Cape Girardeau, MO 63703-5725

Mailing address

PO Box 801143
Kansas City, MO 64180-1143
Phone (573) 331-5583

Other practice location 1

1702 N Kingshighway St
Cape Girardeau, MO 63701-2122
Phone (573) 339-0483

Other identifiers 4

IdentifierTypeStateIssuer
208668004MedicaidMO
603526OtherMOANTHEM BCBS
P00779915OtherMORR MCR
333547OtherHEALTHLINK

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MO
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20060330000309 MO Practitioner - Family Practice 0749298974 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
University of Missouri, Columbia School of Medicine, 1994
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Cross Trails Medical CenterGroup PAC ID 8820902851, 9 clinicians

Practice addresses (Care Compare)

408 S Broadview St
Cape Girardeau, MO 63703-5725
Phone (573) 332-0808

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Cross Trails Medical Center CurrentSince Aug 5, 2024 Accepting new patients
Cross Trails Medical Center CurrentSince Aug 5, 2024 Accepting new patients
Global Wound Care Medical Group CurrentSince Feb 19, 2024 Accepting new patients
Cross Trails Medical Center Past Accepting new patients

Locations

5901 W Century Blvd
Ste 750
Los Angeles, CA 90045
Phone (323) 843-2861

2430 Golden St
Cape Girardeau, MO 63703
Phone (573) 332-0808

408 S Broadview St
Cpe Girardeau, MO 63703
Phone (573) 332-0808

109 State Highway 51 N
Marble Hill, MO 63764
Phone (573) 238-1110

1314 Brenda Ave
Perryville, MO 63775
Phone (573) 332-0808

7777 Bonhomme Ave
Ste 1800
Saint Louis, MO 63105
Phone (314) 209-2800

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 3

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1151625600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1722816000000",
    "number": "1720017296",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 801143",
            "city": "KANSAS CITY",
            "state": "MO",
            "postal_code": "641801143",
            "telephone_number": "573-331-5583",
            "fax_number": "573-331-5079"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "408 S BROADVIEW ST",
            "city": "CAPE GIRARDEAU",
            "state": "MO",
            "postal_code": "637035725",
            "telephone_number": "573-332-0808"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1702 N Kingshighway St",
            "address_purpose": "LOCATION",
            "city": "Cape Girardeau",
            "state": "MO",
            "postal_code": "637012122",
            "country_code": "US",
            "telephone_number": "573-339-0483",
            "fax_number": "573-339-1876",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CROSNOE",
        "first_name": "JANNA",
        "middle_name": "R",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-06-30",
        "last_updated": "2024-08-05",
        "certification_date": "2024-08-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MO",
            "license": "106393",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "208668004",
            "state": "MO"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM BCBS",
            "identifier": "603526",
            "state": "MO"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MCR",
            "identifier": "P00779915",
            "state": "MO"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTHLINK",
            "identifier": "333547",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Cape Girardeau, MO

Sources for this page

Verify at the official NPI Registry.