Nicole Connelly, FNP-C

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

0024176013 Issued in VA

Practice address

4200 Regent St Ste 200
Columbus, OH 43219-6229

Phone

(877) 870-1775

Fax

(614) 968-8840

NPI assigned

Apr 20, 2018

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

Other identifiers 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Merit-based Incentive Payment System (MIPS)

Final score

55.59 of 100Reported as group

Quality

26.02

Promoting interoperability

100

Improvement activities

0

Cost

75.94

Medicare enrollment (NPD)

Enrolled

Practice roles

Interoperability endpoints

• Direct secure messaging: nicole.connelly@lmg1.eclinicaldirectplus.com

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.

• Penguin Pediatrics

  • Pediatrics Physician
  • Ashburn, VA
  • NPI 1982830873
  NPD (past)

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

{
    "created_epoch": "1524182400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1711843200000",
    "number": "1083101489",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "43137 WINTERGROVE DR",
            "city": "ASHBURN",
            "state": "VA",
            "postal_code": "201474457"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4200 REGENT ST STE 200",
            "city": "COLUMBUS",
            "state": "OH",
            "postal_code": "432196229",
            "telephone_number": "877-870-1775",
            "fax_number": "614-968-8840"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CONNELLY",
        "first_name": "NICOLE",
        "credential": "FNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-04-20",
        "last_updated": "2024-03-31",
        "certification_date": "2024-03-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "VA",
            "license": "0024176013",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "30015380170003",
            "state": "VA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1457344962",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• George R. Connell, MD
• Hannah Connell, PTA
• Jeffrey Connell
• Jaclyn Connelly
• Kathryn Anne Connelly
• Shari Connelly
• Turquoise Autumn Connelly, CDCA
• Bessie Conner
• Caitlin Conner
• Carly Rae Conner

• Family Nurse Practitioner in Columbus, OH
• Providers in Columbus, OH by specialty
• Family Nurse Practitioner in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 31, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• 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.