Individual provider Active NPI

Emmalie Bliss Connor, APRN

  • Nurse Practitioner
  • Dover, NH
National Provider Identifier
1023559093
Registry record updated Jun 28, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
086471-23 Issued in NH
Practice address
19 Old Rollinsford Rd BLDG B
Dover, NH 03820-2807
Phone
(603) 516-4265
NPI assigned
Mar 10, 2017
Last updated
Jun 28, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 28, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 086471-23 NH Primary
Acute Care Nurse Practitioner 363LA2100X RN2285154 MA

Addresses

Primary practice location

19 Old Rollinsford Rd BLDG B
Dover, NH 03820-2807

Mailing address

PO Box 412503
Boston, MA 02241-2503
Phone (617) 726-3884

Other practice location 1

55 Fruit St
Ellison 11
Boston, MA 02114-2621
Phone (617) 724-5110

Other identifiers 1

IdentifierTypeStateIssuer
3131690MedicaidNH

Other names 1

  • Emmalie Bliss Norrman Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NH
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

Enrollment IDStateProvider typePAC IDDetails
I20211118002423 NH Practitioner - Nurse Practitioner 8527457225 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Drexel University College of Medicine, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

19 Old Rollinsford Rd
BLDG B
Dover, NH 03820-2807
Phone (603) 516-4265

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
086471-23NHMDNurse Practitioner
RN2285154MAMDAcute Care Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Wentworth Douglass Physician Corporation CurrentSince Nov 29, 2021 Accepting new patients
Wentworth Douglass Physician Corporation CurrentSince Nov 29, 2021 Accepting new patients
Wentworth Douglass Physician Corporation Current Accepting new patients
General Hospital Corp Current Accepting new patients
The General Hospital Corporation Past Accepting new patients
Westchester Neurological Consultant PC Past Accepting new patients

Locations

55 Fruit St
Boston, MA 02114

55 Fruit St
#11
Boston, MA 02114
Phone (617) 724-5110

19 Old Rollinsford Rd
Bldg B
Dover, NH 03820
Phone (603) 516-4265

750 Central Ave
Ste Q
Dover, NH 03820
Phone (603) 742-6030

789 Central Ave
Dover, NH 03820
Phone (603) 740-2832

67 Corporate Dr
Ste 200
Portsmouth, NH 03801
Phone (603) 431-5529

3 Terrascape Pkwy
Somersworth, NH 03878
Phone (603) 609-6726

Interoperability endpoints

  • Direct secure messaging: connor.emmalie.mgh@direct.partners.masshiway.net
  • FHIR API: https://fhir.meditouchehr.com/api/fhir/r4/

Organizations & group practices 6

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.

Hospital & facility affiliations 5

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1489104000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1656374400000",
    "number": "1023559093",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 412503",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "022412503",
            "telephone_number": "617-726-3884"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "19 OLD ROLLINSFORD RD BLDG B",
            "city": "DOVER",
            "state": "NH",
            "postal_code": "038202807",
            "telephone_number": "603-516-4265"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "55 Fruit St",
            "address_2": "Ellison 11",
            "address_purpose": "LOCATION",
            "city": "Boston",
            "state": "MA",
            "postal_code": "021142621",
            "country_code": "US",
            "telephone_number": "617-724-5110",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CONNOR",
        "first_name": "EMMALIE",
        "middle_name": "BLISS",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-03-10",
        "last_updated": "2022-06-28",
        "certification_date": "2022-06-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "NH",
            "license": "086471-23",
            "primary": true
        },
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "MA",
            "license": "RN2285154",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3131690",
            "state": "NH"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "EMMALIE",
            "last_name": "NORRMAN",
            "middle_name": "BLISS",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Dover, NH

Sources for this page

Verify at the official NPI Registry.