Connie Marie Syropoulos, NP-C

Primary specialty

Gerontology Nurse PractitionerTaxonomy code 363LG0600X

License

12218275-4405 Issued in UT

Practice address

922 W Baxter Dr Ste 1110
South Jordan, UT 84095-8613

Phone

(385) 281-9846

NPI assigned

Feb 18, 2015

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

Other names 1

• Connie Wheeler Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

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

{
    "created_epoch": "1424217600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1741219200000",
    "number": "1114319746",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "30625 MARTINDALE RD APT 106",
            "city": "NEW HUDSON",
            "state": "MI",
            "postal_code": "481659839",
            "telephone_number": "313-204-7544",
            "fax_number": "629-837-5940"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "922 W BAXTER DR STE 1110",
            "city": "SOUTH JORDAN",
            "state": "UT",
            "postal_code": "840958613",
            "telephone_number": "385-281-9846"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SYROPOULOS",
        "first_name": "CONNIE",
        "middle_name": "MARIE",
        "credential": "NP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-02-18",
        "last_updated": "2025-03-06",
        "certification_date": "2025-03-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "MT",
            "license": "217324",
            "primary": false
        },
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "UT",
            "license": "12218275-4405",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "CONNIE",
            "last_name": "WHEELER",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Brandi Sweet, LCSW
• Shae Swensen
• Kirsten Michelle Swift, BCBA
• Michael T. Swinyard, MD
• Ric L Sykes, RPH
• Nicholas Takis, DC
• Kristina Lynne Talbert, PSY. D.
• Andrea Talbot, RD
• Julie Tapusoa
• Sumer Tariq

• Gerontology Nurse Practitioner in South Jordan, UT
• Providers in South Jordan, UT by specialty
• Gerontology Nurse Practitioner in Utah

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 6, 2025; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.