Individual provider Active NPI

Connie Hammond

  • Emergency Medicine Physician
  • Peoria, AZ
National Provider Identifier
1376096024
Registry record updated Oct 29, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
AP8713 Issued in AZ
Practice address
7615 W Thunderbird Rd
Ste 106
Peoria, AZ 85381-6083
Phone
(623) 547-6838
NPI assigned
Jul 29, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 29, 2021

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X AP8713 AZ
Family Medicine Physician 207Q00000X AP8713 AZ
Emergency Medicine Physician 207P00000X AP8713 AZ Primary

Addresses

Primary practice location

7615 W Thunderbird Rd
Ste 106
Peoria, AZ 85381-6083

Mailing address

7615 W Thunderbird Rd
Ste 106
Peoria, AZ 85381-6083
Phone (623) 547-6838

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
AP8713AZMDNurse Practitioner

NPI Registry JSON

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

{
    "created_epoch": "1469750400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1635465600000",
    "number": "1376096024",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7615 W THUNDERBIRD RD",
            "address_2": "STE 106",
            "city": "PEORIA",
            "state": "AZ",
            "postal_code": "853816083",
            "telephone_number": "623-547-6838"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7615 W THUNDERBIRD RD",
            "address_2": "STE 106",
            "city": "PEORIA",
            "state": "AZ",
            "postal_code": "853816083",
            "telephone_number": "623-547-6838"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HAMMOND",
        "first_name": "CONNIE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-07-29",
        "last_updated": "2021-10-29",
        "certification_date": "2021-10-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "AZ",
            "license": "AP8713",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "AZ",
            "license": "AP8713",
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "AZ",
            "license": "AP8713",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Peoria, AZ

Sources for this page

Verify at the official NPI Registry.