Loren Connolly, PHD

Primary specialty

PsychologistTaxonomy code 103T00000X

License

B10000554 Issued in DE

Practice address

5601 Loch Raven Blvd
Rehab Department
Baltimore, MD 21239-2945

Phone

(443) 444-4034

NPI assigned

Jan 26, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in DE

Eligible to order & refer

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

Green means eligible to order or refer.

Enrollment records 1

Specialty

Clinical Psychologist

Education

Other, 1997

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Vista Medical Services IncGroup PAC ID 5597743344, 31 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

State licenses

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://fhir-myrecord.cerner.com/r4/5c7467fb-60f9-4172-add4-57667a5dfcfa/

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.

• Vista Medical Services, Inc.

  • Psychiatry Physician
  • Bala Cynwyd, PA
  • NPI 1659452027

  DE

  Medicare reassignment Care Compare group NPD
• Christiana Care Health Services Inc

  • Infectious Disease Physician
  • Wilmington, DE
  • NPI 1326022476
  NPD (past)
• Christiana Care Health Services, Inc

  • Cardiovascular Disease Physician
  • Newark, DE
  • NPI 1003850504
  NPD (past)

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

{
    "created_epoch": "1138233600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1485388800000",
    "number": "1033189550",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "501 LOCH RAVEN BLVD.",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "21239",
            "telephone_number": "443-444-4034"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5601 LOCH RAVEN BLVD",
            "address_2": "REHAB DEPARTMENT",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212392945",
            "telephone_number": "443-444-4034"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CONNOLLY",
        "first_name": "LOREN",
        "credential": "PHD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-01-26",
        "last_updated": "2017-01-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "DE",
            "license": "B10000554",
            "primary": true
        },
        {
            "code": "103TR0400X",
            "taxonomy_group": "",
            "desc": "Psychologist, Rehabilitation",
            "state": "MD",
            "license": "05866",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Warren Edward Conner, LCSW-C
• Connet Pharmacy, LLC
• Caoilfhionn Marie Connolly, MB BCH BAO, MSC.
• Courtney Ting Connolly, MD
• Gillean Kelly Connolly, MD
• Mary Ellen Connolly, N.P.
• Roisin M Connolly, MB
• William J Connolly, L.C.S.W.
• Clara Ellen Connor, CRNP
• John Andrew Connor

• Psychologist in Baltimore, MD
• Providers in Baltimore, MD by specialty
• Psychologist in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 26, 2017; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.