Individual provider Active NPI

Courtney A O'Connor

  • Certified Registered Nurse Anesthetist
  • Manchester, NH
National Provider Identifier
1376004622
Registry record updated May 30, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
125353 Issued in MA
Practice address
1 Elliot Way
Manchester, NH 03103-3599
Phone
(603) 663-2315
Fax
(603) 647-9180
NPI assigned
Mar 28, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 30, 2019

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 065899-21 NH
Certified Registered Nurse Anesthetist 367500000X 125353 MA Primary

Addresses

Primary practice location

1 Elliot Way
Manchester, NH 03103-3599

Mailing address

16 Eskimo Way
North Billerica, MA 01862-2900
Phone (339) 223-9643

Other practice location 1

16 Eskimo Way
North Billerica, MA 01862-2900
Phone (339) 223-9643

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NH

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20191218001566 NH Practitioner - Certified Registered Nurse Anesthetist (Crna) 6507290947 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Amoskeag Anesthesia PLLCGroup PAC ID 1759375983, 165 clinicians

Practice addresses (Care Compare)

1 Elliot Way
Manchester, NH 03103-3502
Phone (603) 663-2431

Hospital & facility affiliations

  • Elliot Hospital Hospital, Manchester, NH, CCN 300012

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Certified Registered Nurse

State licenses

LicenseStateTypeSpecialty
065899-21NHMDRegistered Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
Amoskeag Anesthesia, PLLC Nurse Anesthetist, Certified Registered CurrentSince Oct 22, 2019 Accepting new patients

Locations

185 Queen City Ave
Manchester, NH 03101
Phone (603) 314-6900

1 Elliot Way
Ste 200
Manchester, NH 03103
Phone (603) 623-4640

1 Elliot Way
Manchester, NH 03103
Phone (603) 663-2271

172 Kinsley St
Nashua, NH 03060
Phone (603) 595-3926

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 and National Provider Directory roles.

Hospital & facility affiliations 1

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": "1553731200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1559174400000",
    "number": "1376004622",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16 ESKIMO WAY",
            "city": "NORTH BILLERICA",
            "state": "MA",
            "postal_code": "018622900",
            "telephone_number": "339-223-9643"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 ELLIOT WAY",
            "city": "MANCHESTER",
            "state": "NH",
            "postal_code": "031033599",
            "telephone_number": "603-663-2315",
            "fax_number": "603-647-9180"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "16 Eskimo Way",
            "address_purpose": "LOCATION",
            "city": "North Billerica",
            "state": "MA",
            "postal_code": "018622900",
            "country_code": "US",
            "telephone_number": "339-223-9643",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "O'CONNOR",
        "first_name": "COURTNEY",
        "middle_name": "A",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-03-28",
        "last_updated": "2019-05-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "NH",
            "license": "065899-21",
            "primary": false
        },
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "MA",
            "license": "125353",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Manchester, NH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 30, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • 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.