Jenifer Shanon Conn, APRN-CNP

Primary specialty

Adult Health Nurse PractitionerTaxonomy code 363LA2200X

License

60035 Issued in ID

Practice address

1510 12TH Avenue Rd Ste 200
Nampa, ID 83686

Phone

(208) 302-0600

Fax

(208) 302-0755

NPI assigned

Oct 19, 2010

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in ID, OR2 enrollments

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 2

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

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 and National Provider Directory roles.

• Signify Health Medical Associates, PLLC

  • General Practice Physician
  • Dallas, TX
  • NPI 1750845863

  OR

  Medicare reassignment NPD
• Signify Health, LLC

  • General Practice Physician
  • Dallas, TX
  • NPI 1689158487

  ID

  Medicare reassignment NPD

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

{
    "created_epoch": "1287446400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1562112000000",
    "number": "1467762856",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3340 E GOLDSTONE WAY",
            "city": "MERIDIAN",
            "state": "ID",
            "postal_code": "83642",
            "telephone_number": "208-302-0600",
            "fax_number": "208-302-0755"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1510 12TH AVENUE RD STE 200",
            "city": "NAMPA",
            "state": "ID",
            "postal_code": "83686",
            "telephone_number": "208-302-0600",
            "fax_number": "208-302-0755"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CONN",
        "first_name": "JENIFER",
        "middle_name": "SHANON",
        "credential": "APRN-CNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2010-10-19",
        "last_updated": "2019-07-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WD0400X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Diabetes Educator",
            "state": "ID",
            "license": "N32302",
            "primary": false
        },
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "ID",
            "license": "60035",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "N32302",
            "identifier": "N32302",
            "state": "ID"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "APRN-CNP",
            "identifier": "60035",
            "state": "ID"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Emalie Conant
• Sasha Conant
• Jane Alexandra Conde
• Mark Conlin, RPT
• James Conn
• Damaris Ellen Conrad, PHD, LMFT
• Leslie Contos, PHD, LCPC, NCC,CCMHC
• Cook & Tafoya-Fisher Behavioral Health
• Cook Behavioral Health LLC
• Alyssa Marian Cook, MS

• Adult Health Nurse Practitioner in Nampa, ID
• Providers in Nampa, ID by specialty
• Adult Health Nurse Practitioner in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 3, 2019; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.