Individual provider Active NPI

Anne O'Neal Poore, FNP

  • Family Nurse Practitioner
  • San Rafael, CA
National Provider Identifier
1962611236
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
RN 418826 NP 8392 Issued in CA
Practice address
16 Ritter St
San Rafael, CA 94901-3323
Phone
(415) 457-8182
Fax
(415) 457-3490
NPI assigned
May 22, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X RN 418826 NP 8392 CA Primary

Addresses

Primary practice location

16 Ritter St
San Rafael, CA 94901-3323

Mailing address

80 Baywood Ave
San Anselmo, CA 94960-2509
Phone (415) 457-2586

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

State licenses

LicenseStateTypeSpecialty
RN 418826 NP 8392CAMDFamily Nurse Practitioner

NPI Registry JSON

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

{
    "created_epoch": "1179792000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1962611236",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "80 BAYWOOD AVE",
            "city": "SAN ANSELMO",
            "state": "CA",
            "postal_code": "949602509",
            "telephone_number": "415-457-2586",
            "fax_number": "415-482-9365"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16 RITTER ST",
            "city": "SAN RAFAEL",
            "state": "CA",
            "postal_code": "949013323",
            "telephone_number": "415-457-8182",
            "fax_number": "415-457-3490"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "POORE",
        "first_name": "ANNE",
        "middle_name": "O'NEAL",
        "name_prefix": "Mrs.",
        "credential": "FNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-05-22",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CA",
            "license": "RN 418826  NP 8392",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Rafael, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.