Connie Ahn, NP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

AP61185290 Issued in WA

Practice address

406 SE 131St Ave Ste 104
Vancouver, WA 98683-4031

Phone

(877) 522-1275

NPI assigned

Jun 9, 2021

Last updated

Nov 13, 2021By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in WA

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

George Washington University School of Medicine, 2021

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

PeacehealthGroup PAC ID 8820178288, 245 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Peacehealth Southwest Medical Cente Hospital, Vancouver, WA, CCN 500050
• Peacehealth St John Medical Center Hospital, Longview, WA, CCN 500041

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: cahn549001@direct.peacehealth.org

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.

• Peacehealth

  dba PeaceHealth Medical Group

  • Surgery Physician
  • Vancouver, WA
  • NPI 1609061969
  Medicare reassignment Care Compare group NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Peacehealth

  dba PeaceHealth SW Heart & Vascular Center

  • Cardiovascular Disease Physician
  • Vancouver, WA
  • NPI 1003194911

  Hospital

  Care Compare affiliation
• Peacehealth

  dba St. John Medical Center

  • General Acute Care Hospital
  • Longview, WA
  • NPI 1073510277
  Care Compare affiliation
• Peacehealth

  dba PeaceHealth Southwest Medical Center

  • General Acute Care Hospital
  • Vancouver, WA
  • NPI 1134178999
  Care Compare affiliation

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

{
    "created_epoch": "1623196800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1636761600000",
    "number": "1104493865",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 NE MOTHER JOSEPH PL STE 330",
            "city": "VANCOUVER",
            "state": "WA",
            "postal_code": "986643288",
            "telephone_number": "360-514-2990"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "406 SE 131ST AVE STE 104",
            "city": "VANCOUVER",
            "state": "WA",
            "postal_code": "986834031",
            "telephone_number": "877-522-1275"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "200 NE Mother Joseph Pl Ste 330",
            "address_purpose": "LOCATION",
            "city": "Vancouver",
            "state": "WA",
            "postal_code": "986643288",
            "country_code": "US",
            "telephone_number": "360-514-2990",
            "fax_number": "360-514-3508",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "800 Spruce St",
            "address_purpose": "LOCATION",
            "city": "Philadelphia",
            "state": "PA",
            "postal_code": "191076130",
            "country_code": "US",
            "telephone_number": "215-829-3006",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "AHN",
        "first_name": "CONNIE",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-06-09",
        "last_updated": "2021-11-13",
        "certification_date": "2021-10-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "OR",
            "license": "202105283NP-PP",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "WA",
            "license": "AP61185290",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Stephen J Ahearn, FNP
• Ma Roxanne Tomaquin Aheto, BSN, RN
• Iqro Ali Ahmed
• Tahir Munawar Ahmed, PHARMD
• Byoungchan Ahn, DMD
• Ahrens & Associates Corporation (Maitri Mental Health)
• Dusty Marie Ahrens
• Kendall Alice Aichele, R.PH.
• Aileen T Aiello, MS
• Tracy L Aiello, OTR

• Family Nurse Practitioner in Vancouver, WA
• Providers in Vancouver, WA by specialty
• Family Nurse Practitioner in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 13, 2021; 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.