Annie Rose Condolon-Kohler, NP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

95011293 Issued in CA

Practice address

4520 Business Center Dr
Fairfield, CA 94534-6888

Phone

(707) 646-5500

NPI assigned

Apr 13, 2019

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in CA

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

Other, 2018

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Northbay Health Medical FoundationGroup PAC ID 3274010871, 207 clinicians

Northbay Physicians Surgery Center, LLCGroup PAC ID 0042122244, 336 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Northbay Medical Center Hospital, Fairfield, CA, CCN 050367

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Northbay Health Medical Foundation

  • Internal Medicine Physician
  • Fairfield, CA
  • NPI 1760283527
  Medicare reassignment Care Compare group NPD
• Northbay Healthcare Group

  • General Acute Care Hospital
  • Fairfield, CA
  • NPI 1821147786
  Medicare reassignment Care Compare group NPD
• Northbay Healthcare Group

  • Multi-Specialty Clinic/Center
  • Vacaville, CA
  • NPI 1760534713
  NPD

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

• Northbay Healthcare Group

  • General Acute Care Hospital
  • Fairfield, CA
  • NPI 1821147786
  Care Compare affiliation

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

{
    "created_epoch": "1555113600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1555113600000",
    "number": "1174086359",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1724 ASHTREE CT",
            "city": "FAIRFIELD",
            "state": "CA",
            "postal_code": "945343964",
            "telephone_number": "484-866-0654"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4520 BUSINESS CENTER DR",
            "city": "FAIRFIELD",
            "state": "CA",
            "postal_code": "945346888",
            "telephone_number": "707-646-5500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CONDOLON-KOHLER",
        "first_name": "ANNIE ROSE",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-04-13",
        "last_updated": "2019-04-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CA",
            "license": "95011293",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Community Dental Services
• Community Medical Specialists Inc
• Compass Connections
• Michael Conard, RAD-T
• Alfonso Conchas
• Fadila A Congestio
• Maria Conley, MD
• Connect Transport LLC
• Megan Connick, M.D.
• Rozell Constantino

• Family Nurse Practitioner in Fairfield, CA
• Providers in Fairfield, CA by specialty
• Family Nurse Practitioner in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 13, 2019; 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.