Lisa Connelly, FNP-C

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

77645 Issued in KS

Practice address

420 W 15TH Ave
Emporia, KS 66801-5367

Phone

(620) 251-2400

Fax

(620) 251-1619

NPI assigned

Mar 14, 2017

Last updated

Apr 17, 2018By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in KS, OK2 enrollments

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 2

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Coffeyville Regional Medical Center Inc

  • Anesthesiology Physician
  • Coffeyville, KS
  • NPI 1265550891
  Medicare reassignment NPD
• Altea Medical Oklahoma PLLC

  • Geriatric Medicine (Internal Medicine) Physician
  • Oklahoma City, OK
  • NPI 1750105946
  Medicare reassignment NPD
• Coffeyville Regional Medical Center, Inc.

  • Critical Access Hospital
  • Coffeyville, KS
  • NPI 1285600379
  NPD
• Coffeyville Regional Medical Center, Inc

  • Family Medicine Physician
  • Coffeyville, KS
  • NPI 1407147903
  NPD (past)
• Tomorrow's Technology Today

  • Clinical Medical Laboratory
  • Coffeyville, KS
  • NPI 1750493144
  NPD (past)

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

{
    "created_epoch": "1489449600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1523923200000",
    "number": "1710428461",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1505 W 4TH ST",
            "city": "COFFEYVILLE",
            "state": "KS",
            "postal_code": "673373307",
            "telephone_number": "620-251-2400",
            "fax_number": "620-251-1619"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "420 W 15TH AVE",
            "city": "EMPORIA",
            "state": "KS",
            "postal_code": "668015367",
            "telephone_number": "620-251-2400",
            "fax_number": "620-251-1619"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CONNELLY",
        "first_name": "LISA",
        "credential": "FNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-03-14",
        "last_updated": "2018-04-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "KS",
            "license": "77645",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Common Ground Mental Wellness, LLC (Common Ground Mental Wellness)
• Community Connections
• Community Healthcare Collective Inc (Newman Community Rx)
• Verlin Conkle
• Mary Ellen Conley, MS,LPC
• Jerry L. Conrade
• Joseph Patrick Conroy, CRNA
• Janice Leann Cook, OTR/L
• Bethany L. Cooper
• Chloe Cope

• Family Nurse Practitioner in Emporia, KS
• Providers in Emporia, KS by specialty
• Family Nurse Practitioner in Kansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 17, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.