Connor Randall Overby, PMHNP-BC

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

1-153880 Issued in AL

Practice address

1909 Commerce Ave
Cullman, AL 35055-6151

Phone

(256) 384-2211

NPI assigned

Feb 2, 2023

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

Medicare fee-for-service enrollment

Enrolled in AL

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

University of South Alabama College of Medicine, 2022

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Wellstone, Inc.Group PAC ID 9739070046, 18 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Wellstone, Inc.

  dba WellStone Behavioral Health

  • Mental Health Counselor
  • Huntsville, AL
  • NPI 1407809213
  Medicare reassignment Care Compare group NPD
• Alabama Mental Healthcare, LLC

  • Psychiatric/Mental Health Nurse Practitioner
  • Guntersville, AL
  • NPI 1841053659
  NPD Authorized official

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

{
    "created_epoch": "1675296000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1724803200000",
    "number": "1386340198",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1241 BLOUNT AVE",
            "city": "GUNTERSVILLE",
            "state": "AL",
            "postal_code": "359761831",
            "telephone_number": "256-751-2201"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1909 COMMERCE AVE",
            "city": "CULLMAN",
            "state": "AL",
            "postal_code": "350556151",
            "telephone_number": "256-384-2211"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OVERBY",
        "first_name": "CONNOR",
        "middle_name": "RANDALL",
        "name_prefix": "Mr.",
        "credential": "PMHNP-BC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2023-02-02",
        "last_updated": "2024-08-28",
        "certification_date": "2024-08-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "AL",
            "license": "1-153880",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Thomas B Oliver, MD
• Omega Hospice, LLC
• Orthopedic & Sportsmedicine Specialists of Cullman PC
• Carrie Elizabeth Jane Osborn, NP-BC
• Alecia Overby, LPC, ADC
• Robert Randolph Page III, M.D.
• Mary Pat Pampu, CRNA
• David M Panella, M.S.
• Brian Parker, M.D.
• Crystal M Parker

• Psychiatric/Mental Health Nurse Practitioner in Cullman, AL
• Providers in Cullman, AL by specialty
• Psychiatric/Mental Health Nurse Practitioner in Alabama

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 28, 2024; 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.