Mildred Catherine Conneely, ARNP

Primary specialty

General Practice PhysicianTaxonomy code 208D00000X

License

F02180856 Issued in FL

Practice address

1701 W Jetton Ave
Tampa, FL 33606-3026

Phone

(813) 786-6364

NPI assigned

May 1, 2018

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in FL

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• HCR Manorcare Medical Services of Florida LLC

  • Nurse Practitioner
  • Toledo, OH
  • NPI 1386750420

  FL

  Medicare reassignment NPD

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

{
    "created_epoch": "1525132800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1525132800000",
    "number": "1023507407",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1701 W JETTON AVE",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336063026",
            "telephone_number": "813-786-6364"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1701 W JETTON AVE",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336063026",
            "telephone_number": "813-786-6364"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CONNEELY",
        "first_name": "MILDRED",
        "middle_name": "CATHERINE",
        "credential": "ARNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-05-01",
        "last_updated": "2018-05-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "FL",
            "license": "F02180856",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Margeaux Briana Connealy, PA-C
• Connect Family Chiropractic Inc.
• Connected Speech Pathology LLC
• Connection Healthcare Inc.
• Connective Health Services
• Candis Miah Connell, PSY.D.
• Carolyn Schroeder Connelly, M.D.
• Devin Connelly
• Zachary Michael Connelly, MD, PHD
• Anna Conner, MD

• General Practice Physician in Tampa, FL
• Providers in Tampa, FL by specialty
• General Practice Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 1, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.