Richard F Connelly, RNC, FNP
Individual provider Active NPI Nurse Practitioner · Hartford, TN
NPI 1043280340 · NPPES record last updated Feb 7, 2013
Key facts
- NPI
- 1043280340
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Nurse Practitioner 363L00000X
- License
- APN6635 (TN)
- Practice address
- 4261 Big Creek Rd
Hartford, TN 37753-2220 - Phone
- (423) 487-2249
- Fax
- (423) 487-3707
- NPI assigned
- Jan 26, 2006
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 8
Hospital & facility affiliations 2
Medicare Care Compare profile
- Specialty
- Nurse Practitioner
- Education
- University of Tennessee, HSC, College of Medicine, 1994
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Rural Medical Services, Inc.
Practice addresses (Care Compare)
4261 Big Creek Rd
Hartford, TN 37753-2220
Phone (423) 487-2249
Hospital & facility affiliations
- Smoky Mountain Home Health and Hospice, Inc
- Tennova Healthcare - Newport Medical Center
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in TN
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20101022001015 | TN | Practitioner - Nurse Practitioner | 4183817018 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| RN90651 | TN | MD | Registered Nurse |
| APN6635 | TN | MD | Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Rural Medical Services, Inc. | Current |
Accepting new patients | |
| Rural Medical Services, Inc. | Current | Accepting new patients | |
| Rural Medical Services, Inc. | Current |
Accepting new patients | |
| Rural Medical Services, Inc. | Current | Accepting new patients | |
| Rural Medical Services, Inc. | Current | Accepting new patients | |
| Rural Medical Services, Inc. | Current | Accepting new patients |
Locations
3222 Chestnut Hill School Rd
Dandridge, TN 37725
Phone (865) 509-6611
4261 Big Creek Rd
Hartford, TN 37753
Phone (423) 487-2249
207 Murray Dr
Newport, TN 37821
Phone (423) 613-3300
229 Hedrick Dr
Newport, TN 37821
Phone (423) 623-1057
103 Wilton Springs Rd
Newport, TN 37821
Phone (423) 487-2222
111 Mockingbird Ave
Parrottsville, TN 37843
Phone (423) 625-1170
Interoperability endpoints
- richard.connelly.p1@direct.ruralmedicalservices.nextgenshare.com
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Registered Nurse | 163W00000X | RN90651 | TN | |
| Nurse Practitioner | 363L00000X | APN6635 | TN | Yes |
Addresses
Primary practice location
4261 Big Creek Rd
Hartford, TN 37753-2220
Mailing address
4261 Big Creek Rd
Hartford, TN 37753-2220
Phone (423) 487-2249
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 100011036 | Other | TN | PHP TENNCARE |
| 3073336 | Other | TN | BLUECARE-C.HILL |
| 3348042 | Medicaid | TN |
Other providers in Hartford, TN
All providers in Hartford, TN · Nurse Practitioner in Tennessee
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Feb 7, 2013. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.