Individual provider Active NPI

Caleb James Conner

  • Family Nurse Practitioner
  • Midland, MI
National Provider Identifier
1124628912
Registry record updated Feb 8, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
4704326252 Issued in MI
Practice address
4000 Wellness Dr
Midland, MI 48670-9548
Phone
(989) 839-3100
NPI assigned
Oct 29, 2020
Last updated
Feb 8, 2025By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 8, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 4704326252 MI Primary

Addresses

Primary practice location

4000 Wellness Dr
Midland, MI 48670-9548

Mailing address

4000 Wellness Dr
Midland, MI 48670-2000

Other practice location 1

725 E State St
Sterling, MI 48659-9548
Phone (989) 654-2491

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
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

Enrollment IDStateProvider typePAC IDDetails
I20201228002500 MI Practitioner - Nurse Practitioner 8325451958 Reassigns benefits to 3 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Degara App, PLLC CurrentSince Sep 17, 2021 Accepting new patients
Mymichigan Medical Center Clare CurrentSince Jul 26, 2022 Accepting new patients
Mymichigan Medical Center Midland Current Accepting new patients
Mymichigan Medical Center Midland CurrentSince Jun 10, 2022 Accepting new patients
Mymichigan Medical Center Clare CurrentSince Jul 26, 2022 Accepting new patients
Mymichigan Medical Center Clare Current Accepting new patients
Mymichigan Medical Center Midland CurrentSince Jun 10, 2022 Accepting new patients

Locations

703 N McEwan St
Clare, MI 48617
Phone (989) 802-5000

401 W Greenlawn Ave
Lansing, MI 48910
Phone (517) 334-2286

4000 Wellness Dr
Midland, MI 48670
Phone (844) 832-1956

50 N Perry St
Pontiac, MI 48342
Phone (248) 338-5300

Organizations & group practices 7

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": "1603929600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1738972800000",
    "number": "1124628912",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4000 WELLNESS DR",
            "city": "MIDLAND",
            "state": "MI",
            "postal_code": "486702000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4000 WELLNESS DR",
            "city": "MIDLAND",
            "state": "MI",
            "postal_code": "486709548",
            "telephone_number": "989-839-3100"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "725 E State St",
            "address_purpose": "LOCATION",
            "city": "Sterling",
            "state": "MI",
            "postal_code": "486599548",
            "country_code": "US",
            "telephone_number": "989-654-2491",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CONNER",
        "first_name": "CALEB",
        "middle_name": "JAMES",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-10-29",
        "last_updated": "2025-02-08",
        "certification_date": "2025-02-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MI",
            "license": "4704326252",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Midland, MI

Sources for this page

Verify at the official NPI Registry.