Individual provider Active NPI

Sharon Dixie McConnell, RN

  • General Practice Registered Nurse
  • Portland, OR
National Provider Identifier
1083693295
Registry record updated Aug 3, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice Registered NurseTaxonomy code 163WG0000X
Practice address
9911 SE Mount Scott Blvd
Portland, OR 97266-6302
Phone
(801) 703-3482
NPI assigned
Jan 16, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 3, 2007

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Registered Nurse 163WG0000X 353858-3102 UT
General Practice Registered Nurse 163WG0000X RN-301406 OH
General Practice Registered Nurse 163WG0000X OR Primary

Addresses

Primary practice location

9911 SE Mount Scott Blvd
Portland, OR 97266-6302

Mailing address

9911 SE Mount Scott Blvd
Portland, OR 97266-6302
Phone (801) 703-3482

Other identifiers 2

IdentifierTypeStateIssuer
RN-301406OtherOHRN LICENSE
353858-3102OtherUTRN LICENSE

Other names 1

  • Sharon Dixie Jonas Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Registered Nurse

State licenses

LicenseStateTypeSpecialty
RN-301406OHMDGeneral Practice Registered Nurse
200741637RNORMDGeneral Practice Registered Nurse
353858-3102UTMDGeneral Practice Registered Nurse

NPI Registry JSON

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

{
    "created_epoch": "1137369600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1186099200000",
    "number": "1083693295",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9911 SE MOUNT SCOTT BLVD",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972666302",
            "telephone_number": "801-703-3482"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9911 SE MOUNT SCOTT BLVD",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972666302",
            "telephone_number": "801-703-3482"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCCONNELL",
        "first_name": "SHARON",
        "middle_name": "DIXIE",
        "credential": "RN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-01-16",
        "last_updated": "2007-08-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WG0000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, General Practice",
            "state": "UT",
            "license": "353858-3102",
            "primary": false
        },
        {
            "code": "163WG0000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, General Practice",
            "state": "OH",
            "license": "RN-301406",
            "primary": false
        },
        {
            "code": "163WG0000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, General Practice",
            "state": "OR",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RN LICENSE",
            "identifier": "RN-301406",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RN LICENSE",
            "identifier": "353858-3102",
            "state": "UT"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "SHARON",
            "last_name": "JONAS",
            "middle_name": "DIXIE",
            "credential": "RN",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Portland, OR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 3, 2007; 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.