Individual provider Active NPI

Alexis Caroline Connolly, APRN

  • Family Nurse Practitioner
  • Bradenton, FL
National Provider Identifier
1235855735
Registry record updated Oct 17, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
APRN11022444 Issued in FL
Practice address
530 5TH St E
Bradenton, FL 34208-2002
Phone
(941) 757-3521
Fax
(941) 714-0869
NPI assigned
Oct 17, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 17, 2022

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 APRN11022444 FL Primary

Addresses

Primary practice location

530 5TH St E
Bradenton, FL 34208-2002

Mailing address

530 5TH St E
Bradenton, FL 34208-2002
Phone (941) 757-3521

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
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
I20221101000413 FL Practitioner - Nurse Practitioner 7012384217 Reassigns benefits to 1 organization

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Patrick J Grablin MD PA CurrentSince Oct 23, 2022 Accepting new patients
Lakewood Ranch Surgical Suites, LLC Current Accepting new patients
Brendon Connolly, MD PL CurrentSince Nov 1, 2022 Accepting new patients

Locations

530 5th St E
Bradenton, FL 34208
Phone (941) 744-9200

4937 Clark Rd
Sarasota, FL 34233
Phone (941) 342-6404

Networks

  • Optimum HealthCare HMO Network
  • Freedom Health HMO Network

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/HFFDAD

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1665964800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1665964800000",
    "number": "1235855735",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "530 5TH ST E",
            "city": "BRADENTON",
            "state": "FL",
            "postal_code": "342082002",
            "telephone_number": "941-757-3521",
            "fax_number": "941-714-0869"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "530 5TH ST E",
            "city": "BRADENTON",
            "state": "FL",
            "postal_code": "342082002",
            "telephone_number": "941-757-3521",
            "fax_number": "941-714-0869"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CONNOLLY",
        "first_name": "ALEXIS",
        "middle_name": "CAROLINE",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-10-17",
        "last_updated": "2022-10-17",
        "certification_date": "2022-10-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "FL",
            "license": "APRN11022444",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bradenton, FL

Sources for this page

Verify at the official NPI Registry.