Individual provider Active NPI

Jennifer Connally, CRNP

  • Acute Care Nurse Practitioner
  • Huntsville, AL
National Provider Identifier
1184028359
Registry record updated Jul 17, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Acute Care Nurse PractitionerTaxonomy code 363LA2100X
License
1-119581 Issued in AL
Practice address
930 Franklin St SE
Huntsville, AL 35801-4312
Phone
(256) 533-3388
Fax
(256) 539-4099
NPI assigned
Oct 17, 2014
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 17, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Acute Care Nurse Practitioner 363LA2100X 1-119581 AL Primary

Addresses

Primary practice location

930 Franklin St SE
Huntsville, AL 35801-4312

Mailing address

930 Franklin St SE
Huntsville, AL 35801-4312
Phone (256) 533-3388

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AL
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
I20150205000685 AL Practitioner - Nurse Practitioner 6800111279 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
University of Alabama School of Medicine, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
HH Heart Center, LLCGroup PAC ID 1951694678, 94 clinicians

Practice addresses (Care Compare)

1041 Balch Rd
Suite 300
Madison, AL 35758-8822
Phone (256) 817-5955

930 Franklin St SE
Huntsville, AL 35801-4312
Phone (256) 539-4080

Hospital & facility affiliations

  • Huntsville Hospital Hospital, Huntsville, AL, CCN 010039
  • Athens Limestone Hospital Hospital, Athens, AL, CCN 010079

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
1-119581ALMDAcute Care Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
HH Heart Center, LLC Acute Care CurrentSince Sep 1, 2016 Accepting new patients

Locations

930 Franklin St SE
Huntsville, AL 35801

1041 Balch Rd
Ste 300
Madison, AL 35758
Phone (256) 325-1540

Organizations & group practices 1

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.

Hospital & facility affiliations 2

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

NPI Registry JSON

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

{
    "created_epoch": "1413504000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1563321600000",
    "number": "1184028359",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "930 FRANKLIN ST SE",
            "city": "HUNTSVILLE",
            "state": "AL",
            "postal_code": "358014312",
            "telephone_number": "256-533-3388",
            "fax_number": "256-539-4099"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "930 FRANKLIN ST SE",
            "city": "HUNTSVILLE",
            "state": "AL",
            "postal_code": "358014312",
            "telephone_number": "256-533-3388",
            "fax_number": "256-539-4099"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CONNALLY",
        "first_name": "JENNIFER",
        "credential": "CRNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-10-17",
        "last_updated": "2019-07-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "AL",
            "license": "1-119581",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Huntsville, AL

Sources for this page

Verify at the official NPI Registry.