Individual provider Active NPI

Connie S Rhodes, ANP

  • Nurse Practitioner
  • Syracuse, NY
National Provider Identifier
1205903473
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
NYF300987 Issued in NY
Practice address
700 E Brighton Avenue
Syracuse, NY 13205
Phone
(315) 413-3279
Fax
(315) 469-6558
NPI assigned
Nov 30, 2006
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X NYF300987 NY Primary

Addresses

Primary practice location

700 E Brighton Avenue
Syracuse, NY 13205

Mailing address

700 E Brighton Avenue
Syracuse, NY 13205
Phone (315) 413-3279

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)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
NYF300987NYMDNurse Practitioner

NPI Registry JSON

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

{
    "created_epoch": "1164844800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1205903473",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "700 E BRIGHTON AVENUE",
            "city": "SYRACUSE",
            "state": "NY",
            "postal_code": "13205",
            "telephone_number": "315-413-3279",
            "fax_number": "315-469-6558"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "700 E BRIGHTON AVENUE",
            "city": "SYRACUSE",
            "state": "NY",
            "postal_code": "13205",
            "telephone_number": "315-413-3279",
            "fax_number": "315-469-6558"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RHODES",
        "first_name": "CONNIE",
        "middle_name": "S",
        "credential": "ANP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-11-30",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "NY",
            "license": "NYF300987",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Syracuse, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.