Individual provider Active NPI

Connie R Bouligny, FNP

  • Family Nurse Practitioner
  • New Orleans, LA
National Provider Identifier
1598810129
Registry record updated Oct 15, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
35423 02872 Issued in LA
Practice address
1450 Poydras Street
1934
New Orleans, LA 70112-2401
Phone
(504) 568-8195
NPI assigned
Jan 24, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 15, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 35423 02872 LA Primary

Addresses

Primary practice location

1450 Poydras Street
1934
New Orleans, LA 70112-2401

Mailing address

5459 Stillwater Dr
New Orleans, LA 70128-3412
Phone (504) 390-5060

Other identifiers 1

IdentifierTypeStateIssuer
2369083MedicaidLA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
35423 02872LAMDFamily Nurse Practitioner

NPI Registry JSON

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

{
    "created_epoch": "1169596800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1444867200000",
    "number": "1598810129",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5459 STILLWATER DR",
            "city": "NEW ORLEANS",
            "state": "LA",
            "postal_code": "701283412",
            "telephone_number": "504-390-5060"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1450 POYDRAS STREET",
            "address_2": "1934",
            "city": "NEW ORLEANS",
            "state": "LA",
            "postal_code": "701122401",
            "telephone_number": "504-568-8195"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOULIGNY",
        "first_name": "CONNIE",
        "middle_name": "R",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-01-24",
        "last_updated": "2015-10-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "LA",
            "license": "35423 02872",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2369083",
            "state": "LA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in New Orleans, LA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 15, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.