Connolly Care Hospice LLC

Primary specialty

Community Based Hospice Care AgencyTaxonomy code 251G00000X

Legal business name

CONNOLLY CARE HOSPICE LLC

Practice address

320 E Warm Springs Rd Ste 2a
Las Vegas, NV 89119-4242

Phone

(702) 426-5165

NPI assigned

Mar 27, 2021

Organization subpart

No

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

Authorized official

Name

Mr. Michael Connolly

Title

Owner

Phone

(702) 426-5165

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in NV

Enrollment records 1

Hospice certification: CCN 291679

Legal name

CONNOLLY CARE HOSPICE LLC

Certification status

Active

Provider type (POS)

Hospice

Participating since

Aug 19, 2024

Last certification

Aug 7, 2024

Organization structure

LLCProprietary

Incorporated

Jul 13, 2020 in NV

Enrollment address

320 E Warm Springs Rd
Ste 2
Las Vegas, NV 89119-4282

Listed as

Connolly Care HospiceCCN 291679

Certified

Aug 19, 2024

Medicare certification status

ActiveFrom the Provider of Services file

Locations

All disclosed owners & managing parties 1

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

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

{
    "created_epoch": "1616803200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1616803200000",
    "number": "1679150361",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2378 VALISSA ST",
            "city": "HENDERSON",
            "state": "NV",
            "postal_code": "890440535"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "320 E WARM SPRINGS RD STE 2A",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891194242",
            "telephone_number": "702-426-5165"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CONNOLLY CARE HOSPICE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-03-27",
        "last_updated": "2021-03-27",
        "certification_date": "2021-03-27",
        "status": "A",
        "authorized_official_last_name": "CONNOLLY",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "702-426-5165",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "251G00000X",
            "taxonomy_group": "",
            "desc": "Hospice Care, Community Based",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BUSINESS LICENSE",
            "identifier": "NV20201834837",
            "state": "NV"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Lisa Marjorie Conners, DO
• Michelle Susan Conners, FNP
• Grissim Clark Connery, DO, RD
• Connexions Mental Health Services, LLC
• Connolly Care for Children LLC
• Connolly Enterprises LLC
• Bryan Connolly
• Nathen Dale Connolly, PHARMD
• Raymond Connolly
• Reina Anne Connolly

• Community Based Hospice Care Agency in Las Vegas, NV
• Providers in Las Vegas, NV by specialty
• Community Based Hospice Care Agency in Nevada

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 27, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; facility enrollments, owners and changes of ownership; Provider of Services certification data.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.