NPIMap

Individual provider Active NPI

Connie Jeanine Lasley, CRNP

  • Nurse Practitioner
  • Andalusia, AL
National Provider Identifier
1548858202
Registry record updated Feb 4, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
1-082667 Issued in AL
Practice address
300 Medical Ave Ste 100
Andalusia, AL 36420-1108
Phone
(334) 222-2393
NPI assigned
Jan 7, 2021
Last updated
Feb 4, 2021By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 4, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 1-082667 AL Primary

Addresses

Primary practice location

300 Medical Ave Ste 100
Andalusia, AL 36420-1108

Mailing address

300 Medical Ave Ste 100
Andalusia, AL 36420-1108
Phone (334) 222-2393

Other names 1

  • Connie J Salter Other name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AL
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20210311002875 AL Practitioner - Nurse Practitioner 0648686865 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

300 Medical Ave
Suite 100
Andalusia, AL 36420-1108
Phone (334) 222-2393

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
100 of 100Reported as group
Promoting interoperability
100
Improvement activities
40

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Andalusia Physician Practices LLC CurrentSince Feb 1, 2021 Accepting new patients
Andalusia Physician Practices LLC CurrentSince Feb 1, 2021 Accepting new patients
Andalusia Physician Practices LLC Current Accepting new patients
Andalusia Physician Practices LLC Nurse Practitioner Past Accepting new patients

Locations

300 Medical Ave
Ste 100
Andalusia, AL 36420
Phone (334) 222-2393

301 Medical Ave
Ste A
Andalusia, AL 36420
Phone (334) 222-9100

301 Medical Ave
Ste C
Andalusia, AL 36420
Phone (334) 222-1211

847 W Bypass
Ste A
Andalusia, AL 36420
Phone (334) 222-1366

Interoperability endpoints

  • Direct secure messaging: connie.lasley.1@19364.direct.athenahealth.com
  • FHIR API: https://api.platform.athenahealth.com/19364/brand/1/csg/21/fhir/r4

Organizations & group practices 4

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.

Hospital & facility affiliations 4

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": "1609977600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1612396800000",
    "number": "1548858202",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "300 MEDICAL AVE STE 100",
            "city": "ANDALUSIA",
            "state": "AL",
            "postal_code": "364201108",
            "telephone_number": "334-222-2393"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "300 MEDICAL AVE STE 100",
            "city": "ANDALUSIA",
            "state": "AL",
            "postal_code": "364201108",
            "telephone_number": "334-222-2393"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LASLEY",
        "first_name": "CONNIE",
        "middle_name": "JEANINE",
        "credential": "CRNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-01-07",
        "last_updated": "2021-02-04",
        "certification_date": "2021-02-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "AL",
            "license": "1-082667",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "CONNIE",
            "last_name": "SALTER",
            "middle_name": "J",
            "credential": "CRNP",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Andalusia, AL

Sources for this page

Verify at the official NPI Registry.