Individual provider Active NPI

Pamela Sue Conn, ANP-C

  • Adult Health Nurse Practitioner
  • Surprise, AZ
National Provider Identifier
1174712491
Registry record updated Oct 23, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Health Nurse PractitionerTaxonomy code 363LA2200X
License
AP2785 Issued in AZ
Practice address
14674 W Mountain View Blvd
Suite 200
Surprise, AZ 85374-2705
Phone
(623) 544-6860
NPI assigned
Oct 23, 2007
Last updated
Oct 23, 2007By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 23, 2007

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 AP2785 AZ Primary

Addresses

Primary practice location

14674 W Mountain View Blvd
Suite 200
Surprise, AZ 85374-2705

Mailing address

14674 W Mountain View Blvd
Suite 200
Surprise, AZ 85374-2705
Phone (623) 544-6860

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AZ
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
I20250305003637 AZ Practitioner - Nurse Practitioner 4880115914 Reassigns benefits to 2 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
AP2785AZMDAdult Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Family Service Agency CurrentSince Dec 15, 2024 Accepting new patients
Community Partners Integrated Healthcare, Inc. CurrentSince Dec 19, 2024 Accepting new patients
Community Partners Integrated Healthcare Inc. CurrentSince Dec 19, 2024 Accepting new patients
Community Partners Integrated Healthcare, Inc. Current Accepting new patients

Locations

1107 S Gilbert Rd
Ste 104
Mesa, AZ 85204
Phone (602) 264-9891

10220 N 31st Ave
Ste 101
Phoenix, AZ 85051
Phone (602) 997-2233

1515 E Osborn Rd
Phoenix, AZ 85014
Phone (602) 604-0000

3342 E Greenway Rd
Ste 108
Phoenix, AZ 85032
Phone (602) 275-2726

4337 W Indian School Rd
Ste 109110
Phoenix, AZ 85031
Phone (602) 233-9401

Interoperability endpoints

  • Direct secure messaging: pamela.conn.p1@direct.cpi.nextgenshare.com

Organizations & group practices 4

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": "1193097600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1193097600000",
    "number": "1174712491",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14674 W MOUNTAIN VIEW BLVD",
            "address_2": "SUITE 200",
            "city": "SURPRISE",
            "state": "AZ",
            "postal_code": "853742705",
            "telephone_number": "623-544-6860"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14674 W MOUNTAIN VIEW BLVD",
            "address_2": "SUITE 200",
            "city": "SURPRISE",
            "state": "AZ",
            "postal_code": "853742705",
            "telephone_number": "623-544-6860"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CONN",
        "first_name": "PAMELA",
        "middle_name": "SUE",
        "name_prefix": "Ms.",
        "credential": "ANP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-10-23",
        "last_updated": "2007-10-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "AZ",
            "license": "AP2785",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Surprise, AZ

Sources for this page

Verify at the official NPI Registry.