Thomas William Connelly Jr., PHD, RN

Primary specialty

Child & Adolescent Psychiatric/Mental Health Registered NurseTaxonomy code 163WP0807X

License

064588-21 Issued in NH

Practice address

64 Main St FL 3
Keene, NH 03431-3701

Phone

(603) 283-1570

NPI assigned

Mar 2, 2023

Sex

Male

Sole proprietor

No

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Philosophy, Registered Nurse

State licenses

Practice roles

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.

• Monadnock Family Services

  • Community/Behavioral Health Agency
  • Keene, NH
  • NPI 1649331224
  NPD (past)

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

{
    "created_epoch": "1677715200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1677715200000",
    "number": "1043919699",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "64 MAIN ST FL 2",
            "city": "KEENE",
            "state": "NH",
            "postal_code": "034313701",
            "telephone_number": "603-357-4400"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "64 MAIN ST FL 3",
            "city": "KEENE",
            "state": "NH",
            "postal_code": "034313701",
            "telephone_number": "603-283-1570"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CONNELLY",
        "first_name": "THOMAS",
        "middle_name": "WILLIAM",
        "name_suffix": "Jr.",
        "credential": "PHD, RN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2023-03-02",
        "last_updated": "2023-03-02",
        "certification_date": "2023-03-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WP0807X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Psychiatric/Mental Health, Child & Adolescent",
            "state": "NH",
            "license": "064588-21",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Richard Comerford, Jr.
• Community Improvement Associates, Inc
• Compass Behavioral Health PLLC
• Michael Joseph Conley, ED.D.
• Connecticut Valley Oral Surgery Associates, P.C.
• Margaret Connor, LCMHC
• Consumer Hearing Consultants New Hampshire Inc
• Antony Contarino, CPO
• Conveneintmd LLC
• Convenientmd - FFS UC LLC

• Child & Adolescent Psychiatric/Mental Health Registered Nurse in Keene, NH
• Providers in Keene, NH by specialty
• Child & Adolescent Psychiatric/Mental Health Registered Nurse in New Hampshire

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 2, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.