Active NPI
Holly Connor, CRNA
- Certified Registered Nurse Anesthetist
- Lenoir City, TN
National Provider Identifier
1013954932
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Certified Registered Nurse Anesthetist
- License
- 11694
- Practice address
- 1130 Timber Ridge Dr
Lenoir City, TN 37771-7642 - Phone
- (504) 352-7219
- NPI assigned
- May 31, 2006
- Last updated
- Apr 2, 2013
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Certified Registered Nurse Anesthetist | 367500000X | 11694 | TN | Primary |
Addresses
Primary practice location
1130 Timber Ridge Dr
Lenoir City, TN 37771-7642
Mailing address
1130 Timber Ridge Dr
Lenoir City, TN 37771-7642
Phone (504) 352-7219
Other identifiers 5
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 100049791 | Other | TN | PHP TENNCARE |
| 4114312 | Other | TN | BLUE CROSS |
| 3635913 | Medicaid | TN | |
| 4114312 | Other | TN | BLUECARE |
| P00277458 | Other | TN | MEDICARE TRAVELERS |
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)
- Not enrolled
- HHS exclusion list flag
- CMS’s directory marks this NPI as on an HHS exclusion list; no matching OIG record was found.
- Credentials
- Certified Registered Nurse
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 11694 | TN | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1149033600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1364860800000",
"number": "1013954932",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1130 TIMBER RIDGE DR",
"city": "LENOIR CITY",
"state": "TN",
"postal_code": "377717642",
"telephone_number": "504-352-7219"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1130 TIMBER RIDGE DR",
"city": "LENOIR CITY",
"state": "TN",
"postal_code": "377717642",
"telephone_number": "504-352-7219"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CONNOR",
"first_name": "HOLLY",
"credential": "CRNA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-05-31",
"last_updated": "2013-04-02",
"status": "A"
},
"taxonomies": [
{
"code": "367500000X",
"taxonomy_group": "",
"desc": "Nurse Anesthetist, Certified Registered",
"state": "TN",
"license": "11694",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "PHP TENNCARE",
"identifier": "100049791",
"state": "TN"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE CROSS",
"identifier": "4114312",
"state": "TN"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "3635913",
"state": "TN"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUECARE",
"identifier": "4114312",
"state": "TN"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDICARE TRAVELERS",
"identifier": "P00277458",
"state": "TN"
}
],
"endpoints": [],
"other_names": []
}Other providers in Lenoir City, TN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 2, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.