Individual provider Active NPI

Andrea Joy Connors, DNP-C

  • Adult Health Nurse Practitioner
  • Willis, MI
National Provider Identifier
1124212113
Registry record updated Jun 13, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Health Nurse PractitionerTaxonomy code 363LA2200X
License
4704239544 Issued in MI
Practice address
10280 Bemis Rd
Willis, MI 48191-9742
Phone
(734) 699-5400
Fax
(734) 699-5455
NPI assigned
Sep 1, 2007
Last updated
Jun 13, 2012By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 13, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Health Nurse Practitioner 363LA2200X 4704239544 MI Primary

Addresses

Primary practice location

10280 Bemis Rd
Willis, MI 48191-9742

Mailing address

25 Owen St
Belleville, MI 48111-2921
Phone (734) 699-5400

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
HHS exclusion list flag
CMS’s directory marks this NPI as on an HHS exclusion list; no matching OIG record was found. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.
Credentials
Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Andrea J Connors, LLC PastSince Apr 30, 2011 Accepting new patients
Home Physicians Past Accepting new patients

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1188604800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1339545600000",
    "number": "1124212113",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "25 OWEN ST",
            "city": "BELLEVILLE",
            "state": "MI",
            "postal_code": "481112921",
            "telephone_number": "734-699-5400",
            "fax_number": "734-699-5455"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10280 BEMIS RD",
            "city": "WILLIS",
            "state": "MI",
            "postal_code": "481919742",
            "telephone_number": "734-699-5400",
            "fax_number": "734-699-5455"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CONNORS",
        "first_name": "ANDREA",
        "middle_name": "JOY",
        "name_prefix": "Ms.",
        "credential": "DNP-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-09-01",
        "last_updated": "2012-06-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "MI",
            "license": "4704239544",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Willis, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 13, 2012; 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.