Active NPI
Carol Ann Concannon, N.P.
- Occupational Health Nurse Practitioner
- Windsor, CT
National Provider Identifier
1093953531
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Health Nurse Practitioner
- License
- 155640NP
- Practice address
- 100 Deerfield Rd
Windsor, CT 06095-4252 - Phone
- (860) 714-9444
- NPI assigned
- Jan 21, 2009
- Last updated
- Dec 27, 2019
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Occupational Health Nurse Practitioner | 363LX0106X | 155640NP | MA | Primary |
Addresses
Primary practice location
100 Deerfield Rd
Windsor, CT 06095-4252
Mailing address
100 Deerfield Rd
Windsor, CT 06095-4252
Phone (860) 714-9444
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)
- Enrolled
- Credentials
- Master of Science - Nursing, Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 155640NP | MA | MD | Occupational Health Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Reliant Medical Group, Inc | Past | Accepting new patients |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
- Physical Therapist
- Worcester, MA
- NPI 1295827962
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1232496000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1577404800000",
"number": "1093953531",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "100 DEERFIELD RD",
"city": "WINDSOR",
"state": "CT",
"postal_code": "060954252",
"telephone_number": "860-714-9444"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "100 DEERFIELD RD",
"city": "WINDSOR",
"state": "CT",
"postal_code": "060954252",
"telephone_number": "860-714-9444"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CONCANNON",
"first_name": "CAROL",
"middle_name": "ANN",
"credential": "N.P.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2009-01-21",
"last_updated": "2019-12-27",
"certification_date": "2019-12-27",
"status": "A"
},
"taxonomies": [
{
"code": "363LX0106X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Occupational Health",
"state": "MA",
"license": "155640NP",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Windsor, CT
- Community Solutions, Inc.
- Compassionate Caregivers LLC
- Complete Care at Kimberly Hall North LLC
- Complete Care at Kimberly Hall South LLC
- Comprehensive Geriatric Dental Care LLC
- Concentra Health Services, Inc. (Concentra Medical Center)
- Connal Physical Therapy Group LLC
- Connecticut CVS Pharmacy LLC (CVS Pharmacy #17291)
- Connecticut CVS Pharmacy, L.L.C. (CVS Pharmacy # 01166)
- Connecticut CVS Pharmacy, L.L.C. (CVS Pharmacy # 00349)
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 27, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.