Individual provider Active NPI

Brandy Danielle Conners, LPN

  • Licensed Practical Nurse
  • Potsdam, NY
National Provider Identifier
1609910694
Registry record updated Jun 30, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Licensed Practical NurseTaxonomy code 164W00000X
License
277829 Issued in NY
Practice address
737 State Highway 72
Potsdam, NY 13676-3411
Phone
(315) 265-5034
NPI assigned
Feb 16, 2007
Last updated
Jun 30, 2008By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 30, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Licensed Practical Nurse 164W00000X 277829 NY Primary

Addresses

Primary practice location

737 State Highway 72
Potsdam, NY 13676-3411

Mailing address

PO Box 587
49 Catherine St
Parishville, NY 13672-0587
Phone (315) 265-3670

Other identifiers 1

IdentifierTypeStateIssuer
02588916MedicaidNY

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

NPI Registry JSON

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

{
    "created_epoch": "1171584000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1214784000000",
    "number": "1609910694",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 587",
            "address_2": "49 CATHERINE ST",
            "city": "PARISHVILLE",
            "state": "NY",
            "postal_code": "136720587",
            "telephone_number": "315-265-3670"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "737 STATE HIGHWAY 72",
            "city": "POTSDAM",
            "state": "NY",
            "postal_code": "136763411",
            "telephone_number": "315-265-5034"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CONNERS",
        "first_name": "BRANDY",
        "middle_name": "DANIELLE",
        "credential": "LPN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-02-16",
        "last_updated": "2008-06-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "NY",
            "license": "277829",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02588916",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Potsdam, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 30, 2008; 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.