Individual provider Active NPI

Elizabeth Ann Connole-Pond, APRN

  • Psychiatric/Mental Health Nurse Practitioner
  • Farmington, CT
National Provider Identifier
1346633435
Registry record updated Oct 5, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
6088 Issued in CT
Practice address
Uconn Medical Group
263 Farmington Avenue
Farmington, CT 06030-0001
Phone
(860) 679-6700
Fax
(860) 679-6736
NPI assigned
Mar 12, 2015
Last updated
Oct 5, 2016By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 5, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 6088 CT Primary

Addresses

Primary practice location

Uconn Medical Group
263 Farmington Avenue
Farmington, CT 06030-0001

Mailing address

Uconn Medical Group
263 Farmington Avenue
Farmington, CT 06030-0001
Phone (860) 679-6700

Other identifiers 1

IdentifierTypeStateIssuer
008057999MedicaidCT

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CT
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
I20160216000951 CT Practitioner - Nurse Practitioner 0840518320 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
State of Connecticut CurrentSince Nov 15, 2016 Accepting new patients
The Charlotte Hungerford Hospital CurrentSince Apr 1, 2019 Accepting new patients
The Charlotte Hungerford Hospital CurrentSince Apr 1, 2019 Accepting new patients
State of Connecticut CurrentSince Nov 15, 2016 Accepting new patients
University of Connecticut Health Center Past Accepting new patients

Locations

10 Talcott Notch Rd
Farmington, CT 06032
Phone (860) 679-6700

263 Farmington Ave
Farmington, CT 06030
Phone (860) 679-4477

540 Litchfield St
Torrington, CT 06790
Phone (860) 496-6361

Organizations & group practices 5

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.

NPI Registry JSON

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

{
    "created_epoch": "1426118400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1475625600000",
    "number": "1346633435",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "UCONN MEDICAL GROUP",
            "address_2": "263 FARMINGTON AVENUE",
            "city": "FARMINGTON",
            "state": "CT",
            "postal_code": "060300001",
            "telephone_number": "860-679-6700",
            "fax_number": "860-679-6736"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "UCONN MEDICAL GROUP",
            "address_2": "263 FARMINGTON AVENUE",
            "city": "FARMINGTON",
            "state": "CT",
            "postal_code": "060300001",
            "telephone_number": "860-679-6700",
            "fax_number": "860-679-6736"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CONNOLE-POND",
        "first_name": "ELIZABETH",
        "middle_name": "ANN",
        "name_prefix": "Ms.",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-03-12",
        "last_updated": "2016-10-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "CT",
            "license": "6088",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "008057999",
            "state": "CT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Farmington, CT

Sources for this page

Verify at the official NPI Registry.