Timothy Conn Jr.

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

874273 Issued in MS

Practice address

5003 Hardy St Ste 200
Hattiesburg, MS 39402-1331

Phone

(601) 261-5700

Fax

(601) 261-5777

NPI assigned

May 1, 2017

Last updated

Apr 21, 2021By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in MS

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

Specialty

Nurse Practitioner

Education

Other, 2017

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Ms Pain and MigraineGroup PAC ID 5496162026, 6 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://fhir-usa.unify.chbase.com/org/covingc-3983785e

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.

• Ms Pain & Migraine

  • Pain Medicine (Psychiatry & Neurology) Physician
  • Hattiesburg, MS
  • NPI 1689270142
  Medicare reassignment Care Compare group NPD
• Covington County Hospital

  dba Medical Center of Magee

  • Rural Health Clinic/Center
  • Magee, MS
  • NPI 1750895611
  Medicare reassignment NPD
• Covington County Hospital

  dba Smith County EH Pro Fees

  • Emergency Medical Services (Emergency Medicine) Physician
  • Raleigh, MS
  • NPI 1003654567
  NPD
• Covington County Hospital

  dba CCH Clinic Seminary

  • Rural Health Clinic/Center
  • Seminary, MS
  • NPI 1134435498
  NPD
• Ms Pain & Migraine

  • Pain Medicine Physician
  • Southaven, MS
  • NPI 1346098035
  NPD
• Thomas R. Blackledge, Jr., MD, PA

  • Family Medicine Physician
  • Magee, MS
  • NPI 1376861757
  NPD

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

{
    "created_epoch": "1493596800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1618963200000",
    "number": "1366977068",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5003 HARDY ST STE 200",
            "city": "HATTIESBURG",
            "state": "MS",
            "postal_code": "394021331",
            "telephone_number": "601-261-5700",
            "fax_number": "601-261-5777"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5003 HARDY ST STE 200",
            "city": "HATTIESBURG",
            "state": "MS",
            "postal_code": "394021331",
            "telephone_number": "601-261-5700",
            "fax_number": "601-261-5777"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CONN",
        "first_name": "TIMOTHY",
        "name_suffix": "Jr.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-05-01",
        "last_updated": "2021-04-21",
        "certification_date": "2021-04-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MS",
            "license": "874273",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "03329291",
            "state": "MS"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NURSE PRACTITIONER LICENSE",
            "identifier": "902061",
            "state": "MS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Shamara Conerly
• Stephen L Conerly, MD
• Sheree Conley-Donaldson, PHD, DNP, FNP, PMHNP
• Heather Conn, FNP, PMHNP-BC
• Richard A Conn, M.D.,
• Connect Care Medical
• Connected Conversations, LLC
• Devonne Angela Conner, LCSW
• Conx Care Corporation
• Juleyanna Coogan

• Family Nurse Practitioner in Hattiesburg, MS
• Providers in Hattiesburg, MS by specialty
• Family Nurse Practitioner in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 21, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.