Individual provider Active NPI

Somatra Lynn Connolly, MSN, RN, PMHNP-BC

  • Psychiatric/Mental Health Nurse Practitioner
  • Chestnut Hill, MA
National Provider Identifier
1003164310
Registry record updated Sep 6, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
2013010380 Issued in MA
Practice address
140 Commonwealth Ave
Chestnut Hill, MA 02467-3800
Phone
(617) 552-3310
NPI assigned
Aug 16, 2012
Last updated
Sep 6, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 6, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 2013010380 MA Primary
Registered Nurse 163W00000X RN2281183 MA

Addresses

Primary practice location

140 Commonwealth Ave
Chestnut Hill, MA 02467-3800

Mailing address

140 Commonwealth Ave
Chestnut Hill, MA 02467-3800

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science - Nursing, Registered Nurse

State licenses

LicenseStateTypeSpecialty
2013010380MAMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Community Counseling of Bristol County Inc CurrentSince Jun 2, 2014 Accepting new patients
Community Counseling of Bristol County, Inc. CurrentSince Jun 2, 2014 Accepting new patients
Square Medical Group LLC PastSince Oct 1, 2013 Accepting new patients

Locations

1 Washington St
Taunton, MA 02780
Phone (508) 828-9116

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1345075200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1662422400000",
    "number": "1003164310",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "140 COMMONWEALTH AVE",
            "city": "CHESTNUT HILL",
            "state": "MA",
            "postal_code": "024673800"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "140 COMMONWEALTH AVE",
            "city": "CHESTNUT HILL",
            "state": "MA",
            "postal_code": "024673800",
            "telephone_number": "617-552-3310"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CONNOLLY",
        "first_name": "SOMATRA",
        "middle_name": "LYNN",
        "credential": "MSN, RN, PMHNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-08-16",
        "last_updated": "2022-09-06",
        "certification_date": "2022-09-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "MA",
            "license": "2013010380",
            "primary": true
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "MA",
            "license": "RN2281183",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chestnut Hill, MA

Sources for this page

Verify at the official NPI Registry.