Active NPI
Anjum Rana, M.D.
- Specialist
- Princeton, WV
National Provider Identifier
1780683961
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Specialist
- License
- 17589
- Practice address
- 144 Undercliff Ter
Princeton, WV 24740-2174 - Phone
- (304) 425-0120
- Fax
- (304) 431-3075
- NPI assigned
- Jul 19, 2005
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Specialist | 174400000X | 17589 | WV | Primary |
| Allergy & Immunology Physician | 207K00000X | 17589 | WV | |
| Pediatrics Physician | 208000000X | 17589 | WV |
Addresses
Primary practice location
144 Undercliff Ter
Princeton, WV 24740-2174
Mailing address
PO Box 5049
Princeton, WV 24740-5049
Phone (304) 425-0120
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0109934000 | Medicaid | WV |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in WV
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20100812000688 | WV | Practitioner - Allergy/Immunology | 7911031927 | Practice locations: Princeton, WV |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 17589 | WV | MD | Allergy & Immunology Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1121731200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1434931200000",
"number": "1780683961",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 5049",
"city": "PRINCETON",
"state": "WV",
"postal_code": "247405049",
"telephone_number": "304-425-0120",
"fax_number": "304-431-3075"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "144 UNDERCLIFF TER",
"city": "PRINCETON",
"state": "WV",
"postal_code": "247402174",
"telephone_number": "304-425-0120",
"fax_number": "304-431-3075"
}
],
"practiceLocations": [],
"basic": {
"last_name": "RANA",
"first_name": "ANJUM",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2005-07-19",
"last_updated": "2015-06-22",
"status": "A"
},
"taxonomies": [
{
"code": "174400000X",
"taxonomy_group": "",
"desc": "Specialist",
"state": "WV",
"license": "17589",
"primary": true
},
{
"code": "207K00000X",
"taxonomy_group": "",
"desc": "Allergy & Immunology",
"state": "WV",
"license": "17589",
"primary": false
},
{
"code": "208000000X",
"taxonomy_group": "",
"desc": "Pediatrics",
"state": "WV",
"license": "17589",
"primary": false
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "0109934000",
"state": "WV"
}
],
"endpoints": [],
"other_names": []
}Other providers in Princeton, WV
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 22, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.