Active NPI
Heather McConnell, PHARM D
- Athletic Trainer
- Holbrook, NY
National Provider Identifier
1104469410
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Athletic Trainer
- License
- PCT.0012668
- Practice address
- 182 Greenbelt Pkwy
Holbrook, NY 11741-4440 - Phone
- (631) 513-1381
- NPI assigned
- Oct 21, 2019
- Last updated
- Oct 21, 2019
- Sex
- Female
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Athletic Trainer | 2255A2300X | PCT.0012668 | CT | Primary |
Addresses
Primary practice location
182 Greenbelt Pkwy
Holbrook, NY 11741-4440
Mailing address
182 Greenbelt Pkwy
Holbrook, NY 11741-4440
Phone (631) 513-1381
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
- Doctor of Pharmacy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PCT.0012668 | CT | MD | Athletic Trainer |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1571616000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1571616000000",
"number": "1104469410",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "182 GREENBELT PKWY",
"city": "HOLBROOK",
"state": "NY",
"postal_code": "117414440",
"telephone_number": "631-513-1381"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "182 GREENBELT PKWY",
"city": "HOLBROOK",
"state": "NY",
"postal_code": "117414440",
"telephone_number": "631-513-1381"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MCCONNELL",
"first_name": "HEATHER",
"credential": "PHARM D",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2019-10-21",
"last_updated": "2019-10-21",
"status": "A"
},
"taxonomies": [
{
"code": "2255A2300X",
"taxonomy_group": "",
"desc": "Specialist/Technologist, Athletic Trainer",
"state": "CT",
"license": "PCT.0012668",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Holbrook, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 21, 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.