Active NPI
Innocent Okwudili Anya, MD
- Psychiatry Physician
- North Kansas City, MO
National Provider Identifier
1811048572
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychiatry Physician
- License
- R9J66
- Practice address
- 2301 Burlington St Ste 200
North Kansas City, MO 64116-3092 - Phone
- (816) 283-3396
- Fax
- (816) 283-3402
- NPI assigned
- Jan 16, 2007
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychiatry Physician | 2084P0800X | R9J66 | MO | Primary |
Addresses
Primary practice location
2301 Burlington St Ste 200
North Kansas City, MO 64116-3092
Mailing address
2301 Burlington St Ste 200
North Kansas City, MO 64116-3092
Phone (816) 283-3396
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 209750322 | Medicaid | MO | |
| R9J66 | Other | MO | LICENSE NUMBER |
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
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20041109000831 | MO | Practitioner - Psychiatry | 3274596309 | Practice locations: Gladstone, MO |
Care Compare profile
Medicare Care Compare- Specialty
- Psychiatry
- Education
- Other, 1985
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
Practice addresses (Care Compare)
3000 NE Brooktree LN
Gladstone, MO 64119-1861
Phone (816) 283-3396
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| R9J66 | MO | MD | Psychiatry Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1168905600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1215993600000",
"number": "1811048572",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2301 BURLINGTON ST STE 200",
"city": "NORTH KANSAS CITY",
"state": "MO",
"postal_code": "641163092",
"telephone_number": "816-283-3396",
"fax_number": "816-283-3402"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2301 BURLINGTON ST STE 200",
"city": "NORTH KANSAS CITY",
"state": "MO",
"postal_code": "641163092",
"telephone_number": "816-283-3396",
"fax_number": "816-283-3402"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ANYA",
"first_name": "INNOCENT",
"middle_name": "OKWUDILI",
"name_prefix": "Dr.",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2007-01-16",
"last_updated": "2008-07-14",
"status": "A"
},
"taxonomies": [
{
"code": "2084P0800X",
"taxonomy_group": "",
"desc": "Psychiatry & Neurology, Psychiatry",
"state": "MO",
"license": "R9J66",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "209750322",
"state": "MO"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "LICENSE NUMBER",
"identifier": "R9J66",
"state": "MO"
}
],
"endpoints": [],
"other_names": []
}Other providers in North Kansas City, MO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 14, 2008; 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.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.