Active NPI
Connie Jo Connolly, RPH
- Pharmacist
- Maquoketa, IA
National Provider Identifier
1316046543
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 17824
- Practice address
- 918 W Platt St
Suite 2
Maquoketa, IA 52060-2038 - Phone
- (563) 652-5611
- Fax
- (563) 652-6242
- NPI assigned
- Sep 22, 2006
- Last updated
- Oct 27, 2008
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 17824 | IA | Primary |
Addresses
Primary practice location
918 W Platt St
Suite 2
Maquoketa, IA 52060-2038
Mailing address
1620 15TH Ave
De Witt, IA 52742-1087
Phone (563) 659-2106
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 Pharmacist
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 17824 | IA | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1158883200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1225065600000",
"number": "1316046543",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1620 15TH AVE",
"city": "DE WITT",
"state": "IA",
"postal_code": "527421087",
"telephone_number": "563-659-2106"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "918 W PLATT ST",
"address_2": "SUITE 2",
"city": "MAQUOKETA",
"state": "IA",
"postal_code": "520602038",
"telephone_number": "563-652-5611",
"fax_number": "563-652-6242"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CONNOLLY",
"first_name": "CONNIE",
"middle_name": "JO",
"credential": "RPH",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-09-22",
"last_updated": "2008-10-27",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "IA",
"license": "17824",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Maquoketa, IA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 27, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.