Provider Demographics
NPI:1881608461
Name:RICE, ANNE L (MD)
Entity type:Individual
Prefix:
First Name:ANNE
Middle Name:L
Last Name:RICE
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 776351
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60677-6351
Mailing Address - Country:US
Mailing Address - Phone:502-588-9490
Mailing Address - Fax:502-272-5116
Practice Address - Street 1:438 ADAM SHEPHERD PKWY
Practice Address - Street 2:SUITE 1
Practice Address - City:SHEPHERDSVILLE
Practice Address - State:KY
Practice Address - Zip Code:40165-6640
Practice Address - Country:US
Practice Address - Phone:502-543-1055
Practice Address - Fax:502-543-1052
Is Sole Proprietor?:No
Enumeration Date:2006-07-28
Last Update Date:2021-12-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY40186208000000X, 207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY50037755OtherPASSPORT - NCMA
KY64126493Medicaid
IN201150450Medicaid
KY114751OtherSIHO - NCMA
KYP01064566OtherRR MEDICARE
KY00546094Medicare Oscar/Certification
KYI 59012Medicare UPIN
KYK042460Medicare PIN
IN201150450Medicaid