Individual provider Active NPI

Conor Nicolis McLaughlin, FNP-C

  • Family Nurse Practitioner
  • Laurel, DE
National Provider Identifier
1326559980
Registry record updated Feb 10, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
LG-0012290 Issued in DE
Practice address
30549 Sussex Hwy
Laurel, DE 19956-3891
Phone
(302) 297-2585
NPI assigned
Oct 23, 2017
Last updated
Feb 10, 2023By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 10, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X LG-0012290 DE Primary
Critical Care Medicine Registered Nurse 163WC0200X L1-0046933 DE

Addresses

Primary practice location

30549 Sussex Hwy
Laurel, DE 19956-3891

Mailing address

30549 Sussex Hwy
Laurel, DE 19956-3891

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in DE
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
I20230428002474 DE Practitioner - Nurse Practitioner 6608231444 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Tidalhealth Physician Network, Inc.Group PAC ID 7315901253, 115 clinicians
Select Physical Therapy Holdings IncGroup PAC ID 9537076401, shared by 76 NPIs, 1,992 clinicians

Practice addresses (Care Compare)

Seaford, DE 19973
Phone 30262966118802

1305 S Salisbury Blvd
Suite 5
Salisbury, MD 21801-6845
Phone (667) 253-2323

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
L1-0046933DEMDCritical Care Medicine Registered Nurse
LG-0012290DEMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Tidalhealth Physician Network, Inc. CurrentSince Apr 10, 2023 Accepting new patients

Locations

30549 Sussex Hwy
Laurel, DE 19956
Phone (302) 715-5214

801 Middleford Rd
Seaford, DE 19973
Phone (302) 628-9178

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 4

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": "1508716800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1675987200000",
    "number": "1326559980",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "30549 SUSSEX HWY",
            "city": "LAUREL",
            "state": "DE",
            "postal_code": "199563891"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "30549 SUSSEX HWY",
            "city": "LAUREL",
            "state": "DE",
            "postal_code": "199563891",
            "telephone_number": "302-297-2585"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCLAUGHLIN",
        "first_name": "CONOR",
        "middle_name": "NICOLIS",
        "credential": "FNP-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-10-23",
        "last_updated": "2023-02-10",
        "certification_date": "2023-02-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "DE",
            "license": "LG-0012290",
            "primary": true
        },
        {
            "code": "163WC0200X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Critical Care Medicine",
            "state": "DE",
            "license": "L1-0046933",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Laurel, DE

Sources for this page

Verify at the official NPI Registry.