Individual provider Active NPI

Amy Marie O'Connor, RN, BSN, PMH-BC

  • Psychiatric/Mental Health Registered Nurse
  • Howards Grove, WI
National Provider Identifier
1679464069
Registry record updated Jul 14, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Registered NurseTaxonomy code 163WP0808X
License
144309-30 Issued in WI
Practice address
402 Roosevelt Ave
Howards Grove, WI 53083-1007
Phone
(920) 946-3947
NPI assigned
Jul 14, 2025
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 14, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Registered Nurse 163WP0808X 144309-30 WI Primary

Addresses

Primary practice location

402 Roosevelt Ave
Howards Grove, WI 53083-1007

Mailing address

402 Roosevelt Ave
Howards Grove, WI 53083-1007
Phone (920) 946-3947

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
Credentials
Bachelor on Science - Nursing, Registered Nurse

State licenses

LicenseStateTypeSpecialty
144309-30WIMDPsychiatric/Mental Health Registered Nurse

NPI Registry JSON

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

{
    "created_epoch": "1752451200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1752451200000",
    "number": "1679464069",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "402 ROOSEVELT AVE",
            "city": "HOWARDS GROVE",
            "state": "WI",
            "postal_code": "530831007",
            "telephone_number": "920-946-3947"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "402 ROOSEVELT AVE",
            "city": "HOWARDS GROVE",
            "state": "WI",
            "postal_code": "530831007",
            "telephone_number": "920-946-3947"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "O'CONNOR",
        "first_name": "AMY",
        "middle_name": "MARIE",
        "credential": "RN, BSN, PMH-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-07-14",
        "last_updated": "2025-07-14",
        "certification_date": "2025-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WP0808X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Psychiatric/Mental Health",
            "state": "WI",
            "license": "144309-30",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Howards Grove, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 14, 2025; 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.