Individual provider Active NPI

Marlon McConner, RN

  • Registered Nurse
  • Nevada City, CA
National Provider Identifier
1306204508
Registry record updated Feb 2, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered NurseTaxonomy code 163W00000X
License
95042263 Issued in CA
Practice address
24077 State Highway 49
Nevada City, CA 95959-8519
Phone
(530) 265-9057
Fax
(530) 292-3803
NPI assigned
Feb 2, 2016
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 2, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 95042263 CA Primary

Addresses

Primary practice location

24077 State Highway 49
Nevada City, CA 95959-8519

Mailing address

24077 State Highway 49
Nevada City, CA 95959-8519
Phone (530) 265-9057

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)
Not enrolled
Credentials
Registered Nurse

State licenses

LicenseStateTypeSpecialty
95042263CAMDRegistered Nurse

NPI Registry JSON

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

{
    "created_epoch": "1454371200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1454371200000",
    "number": "1306204508",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "24077 STATE HIGHWAY 49",
            "city": "NEVADA CITY",
            "state": "CA",
            "postal_code": "959598519",
            "telephone_number": "530-265-9057",
            "fax_number": "530-292-3803"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "24077 STATE HIGHWAY 49",
            "city": "NEVADA CITY",
            "state": "CA",
            "postal_code": "959598519",
            "telephone_number": "530-265-9057",
            "fax_number": "530-292-3803"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCCONNER",
        "first_name": "MARLON",
        "credential": "RN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-02-02",
        "last_updated": "2016-02-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "CA",
            "license": "95042263",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Nevada City, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 2, 2016; 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.