Individual provider Active NPI

Connie Jian Hui Li, MD

  • Pediatrics Physician
  • Ventura, CA
National Provider Identifier
1659429678
Registry record updated Mar 20, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
A87985 Issued in CA
Practice address
200 S Wells Rd
Suite 200
Ventura, CA 93004-1377
Phone
(805) 659-1740
Fax
(805) 659-9959
NPI assigned
Jan 8, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 20, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X A87985 CA Primary

Addresses

Primary practice location

200 S Wells Rd
Suite 200
Ventura, CA 93004-1377

Mailing address

200 S Wells Rd
Suite 200
Ventura, CA 93004-1377
Phone (805) 659-1740

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20161125000026 CA Order and Referring Only - Pediatric MedicinePractitioner - Pediatric Medicine 2365538527

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
87985CAMDMarriage & Family Therapist

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

NPI Registry JSON

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

{
    "created_epoch": "1168214400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1363737600000",
    "number": "1659429678",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 S WELLS RD",
            "address_2": "SUITE 200",
            "city": "VENTURA",
            "state": "CA",
            "postal_code": "930041377",
            "telephone_number": "805-659-1740",
            "fax_number": "805-659-9959"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 S WELLS RD",
            "address_2": "SUITE 200",
            "city": "VENTURA",
            "state": "CA",
            "postal_code": "930041377",
            "telephone_number": "805-659-1740",
            "fax_number": "805-659-9959"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LI",
        "first_name": "CONNIE",
        "middle_name": "JIAN HUI",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-01-08",
        "last_updated": "2013-03-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "CA",
            "license": "A87985",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ventura, CA

Sources for this page

Verify at the official NPI Registry.