Individual provider Active NPI

Jacqueline Connor, AU. D.

  • Audiologist
  • Salem, MA
National Provider Identifier
1457443129
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
AudiologistTaxonomy code 231H00000X
License
217 Issued in MA
Practice address
55 Highland Ave
Suite 201
Salem, MA 01970-2100
Phone
(978) 745-6601
NPI assigned
Sep 29, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Audiologist 231H00000X 217 MA Primary

Addresses

Primary practice location

55 Highland Ave
Suite 201
Salem, MA 01970-2100

Mailing address

55 Highland Ave
Suite 201
Salem, MA 01970-2100
Phone (978) 745-6601

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20090303000581 MA Practitioner - Qualified Audiologist 1850457672 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Qualified Audiologist
Education
Other, 2003
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
North Shore Ear, Nose and Throat Associates, PCGroup PAC ID 9032138367, 17 clinicians

Practice addresses (Care Compare)

104 Endicott St
Suite 100
Danvers, MA 01923-0009
Phone (978) 745-6601

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
217MAMDAcupuncturist

Practice roles

OrganizationSpecialtyStatusNew patients
North Shore Ear, Nose & Throat Associates, PC CurrentSince Oct 1, 2008 Accepting new patients

Locations

104 Endicott St
Ste 100
Danvers, MA 01923
Phone (978) 745-6601

55 Highland Ave
Ste 201
Salem, MA 01970
Phone (978) 745-6601

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.

NPI Registry JSON

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

{
    "created_epoch": "1159488000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1457443129",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "55 HIGHLAND AVE",
            "address_2": "SUITE 201",
            "city": "SALEM",
            "state": "MA",
            "postal_code": "019702100",
            "telephone_number": "978-745-6601"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "55 HIGHLAND AVE",
            "address_2": "SUITE 201",
            "city": "SALEM",
            "state": "MA",
            "postal_code": "019702100",
            "telephone_number": "978-745-6601"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CONNOR",
        "first_name": "JACQUELINE",
        "credential": "AU. D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-09-29",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "231H00000X",
            "taxonomy_group": "",
            "desc": "Audiologist",
            "state": "MA",
            "license": "217",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Salem, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.