NPIMap

Individual provider Active NPI

Kristi Brooke Conoly, APRN

  • Psychiatric/Mental Health Nurse Practitioner
  • Tallahassee, FL
National Provider Identifier
1679145353
Registry record updated Jul 21, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
11014142 Issued in FL
Practice address
2634 Capital Cir NE
Tallahassee, FL 32308-4106
Phone
(850) 523-3333
NPI assigned
Jul 13, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X 11014142 FL
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 11014142 FL Primary

Addresses

Primary practice location

2634 Capital Cir NE
Tallahassee, FL 32308-4106

Mailing address

1590 Faceville Attapulgus Rd
Bainbridge, GA 39819-6669
Phone (229) 400-2625

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
11014142FLMDMental Health Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Brooke Haven PLLC Psychiatric/Mental Health Current Accepting new patients
Florida Therapy Services, Inc PastSince Jul 17, 2021 Accepting new patients
Apalachee Center Inc Past Accepting new patients
Apalachee Center Inc Past Accepting new patients
Apalachee Center, Inc. Past Accepting new patients
Apalachee Center Inc Past Accepting new patients
Apalachee Center Inc Past Accepting new patients
Apalachee Center Inc Past Accepting new patients

Organizations & group practices 8

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.

NPI Registry JSON

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

{
    "created_epoch": "1626134400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1626825600000",
    "number": "1679145353",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1590 FACEVILLE ATTAPULGUS RD",
            "city": "BAINBRIDGE",
            "state": "GA",
            "postal_code": "398196669",
            "telephone_number": "229-400-2625"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2634 CAPITAL CIR NE",
            "city": "TALLAHASSEE",
            "state": "FL",
            "postal_code": "323084106",
            "telephone_number": "850-523-3333"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CONOLY",
        "first_name": "KRISTI",
        "middle_name": "BROOKE",
        "name_prefix": "Ms.",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-07-13",
        "last_updated": "2021-07-21",
        "certification_date": "2021-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "FL",
            "license": "11014142",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "FL",
            "license": "11014142",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tallahassee, FL

Sources for this page

Verify at the official NPI Registry.