Active NPI
Munazza Anis, MD
- Diagnostic Radiology Physician
- Charleston, SC
National Provider Identifier
1831174861
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Diagnostic Radiology Physician
- License
- 28609
- Practice address
- 171 Ashley Ave
Charleston, SC 29425-0100 - Phone
- (843) 792-1414
- NPI assigned
- Dec 13, 2005
- Last updated
- Sep 27, 2011
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Diagnostic Radiology Physician | 2085R0202X | 223470 | MA | |
| Diagnostic Radiology Physician | 2085R0202X | 28609 | SC | Primary |
Addresses
Primary practice location
171 Ashley Ave
Charleston, SC 29425-0100
Mailing address
PO Box 751461
Charlotte, NC 28275-1461
Phone (843) 792-6200
Other identifiers 4
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 2103451 | Medicaid | MA | |
| 286096 | Medicaid | SC | |
| J 28800 | Other | MA | BLUE CROSS BLUE SHIELD |
| 468273 | Other | MA | TUFTS HEALTH CARE |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 223470 | MA | MD | Diagnostic Radiology Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Brigham and Womens Physicians Organization Inc | Diagnostic Radiology | Past | Accepting new patients |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
- Diagnostic Radiology Physician
- Boston, MA
- NPI 1265464598
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1134432000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1317081600000",
"number": "1831174861",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 751461",
"city": "CHARLOTTE",
"state": "NC",
"postal_code": "282751461",
"telephone_number": "843-792-6200"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "171 ASHLEY AVE",
"city": "CHARLESTON",
"state": "SC",
"postal_code": "294250100",
"telephone_number": "843-792-1414"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ANIS",
"first_name": "MUNAZZA",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2005-12-13",
"last_updated": "2011-09-27",
"status": "A"
},
"taxonomies": [
{
"code": "2085R0202X",
"taxonomy_group": "",
"desc": "Radiology, Diagnostic Radiology",
"state": "MA",
"license": "223470",
"primary": false
},
{
"code": "2085R0202X",
"taxonomy_group": "",
"desc": "Radiology, Diagnostic Radiology",
"state": "SC",
"license": "28609",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "2103451",
"state": "MA"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "286096",
"state": "SC"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE CROSS BLUE SHIELD",
"identifier": "J 28800",
"state": "MA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "TUFTS HEALTH CARE",
"identifier": "468273",
"state": "MA"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Charleston, SC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 27, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.