Jacquelynn R McConnaughey

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

APRN.CNP.0036944 Issued in OH

Practice address

2107 Rombach Ave
Wilmington, OH 45177-2099

Phone

(937) 383-1040

NPI assigned

Aug 5, 2024

Sex

Female

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

Enrolled in OH

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

Specialty

Nurse Practitioner

Education

Other, 2024

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Greater Tomorrow Health LLCGroup PAC ID 6709157308, 9 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

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.

• Greater Tomorrow Health, LLC

  • Urgent Care Clinic/Center
  • Wilmington, OH
  • NPI 1992230833
  Medicare reassignment Care Compare group NPD
• Alliance Physicians Inc

  • Family Medicine Physician
  • Kettering, OH
  • NPI 1437125572
  NPD (past)

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

{
    "created_epoch": "1722816000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1722816000000",
    "number": "1073343091",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "229 NORTH ST",
            "city": "GREENFIELD",
            "state": "OH",
            "postal_code": "451231333",
            "telephone_number": "937-509-0542"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2107 ROMBACH AVE",
            "city": "WILMINGTON",
            "state": "OH",
            "postal_code": "451772099",
            "telephone_number": "937-383-1040"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCCONNAUGHEY",
        "first_name": "JACQUELYNN",
        "middle_name": "R",
        "name_prefix": "Mrs.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-08-05",
        "last_updated": "2024-08-05",
        "certification_date": "2024-07-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "OH",
            "license": "APRN.CNP.0036944",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• J Brett Massie, EDD, ATC
• Brittany R Mathis, LSW
• Thomas P. Matrka, MD
• Chassity Matynka, LPN
• Heather L McAlein
• Kayla McCord
• Molly Catherine McDermott, M.A., SLP-CCC
• Samantha McGraw, QMHP
• Amanda Kaye McGuire-Bloom
• Roseanne Elizabeth McKay, CRNP

• Nurse Practitioner in Wilmington, OH
• Providers in Wilmington, OH by specialty
• Nurse Practitioner in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 5, 2024; 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.