Individual provider Active NPI

Gina M Connerton, MLP-NP

  • Neonatal Nurse Practitioner
  • Providence, RI
National Provider Identifier
1720399793
Registry record updated Jun 24, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neonatal Nurse PractitionerTaxonomy code 363LN0000X
License
20010098 Issued in RI
Practice address
101 Dudley St
Providence, RI 02905-2401
Phone
(401) 274-1100
NPI assigned
Jun 24, 2010
Last updated
Jun 24, 2010By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 24, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Neonatal Nurse Practitioner 363LN0000X 20010098 RI Primary

Addresses

Primary practice location

101 Dudley St
Providence, RI 02905-2401

Mailing address

11 Dudley Ave S
Middletown, RI 02842-5421
Phone (401) 847-5501

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in RI
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 1

Enrollment IDStateProvider typePAC IDDetails
I20150608000312 RI Practitioner - Nurse Practitioner 9436470168 Reassigns benefits to 3 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
20010098RIMDNeonatal Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Affinity Physicians LLC CurrentSince Oct 19, 2019 Accepting new patients
Newport Hospital CurrentSince May 16, 2017 Accepting new patients
Affinity Physicians LLC. CurrentSince Oct 19, 2019 Accepting new patients
Newport Hospital CurrentSince May 16, 2017 Accepting new patients
Silver Spring Health Care Management, Inc. Neonatal CurrentSince Jan 1, 2015 Accepting new patients
Silver Spring Health Care Management, Inc. Neonatal CurrentSince Jan 1, 2015 Accepting new patients

Locations

11 Friendship St
Newport, RI 02840
Phone (401) 845-1110

101 Dudley St
Providence, RI 02905
Phone (401) 453-7950

100 Kenyon Ave
Wakefield, RI 02879
Phone (401) 782-8000

70 Kenyon Ave
Unit 211
Wakefield, RI 02879
Phone (401) 789-8543

455 Toll Gate Rd
Warwick, RI 02886
Phone (401) 737-7000

Organizations & group practices 6

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.

NPI Registry JSON

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

{
    "created_epoch": "1277337600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1277337600000",
    "number": "1720399793",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11 DUDLEY AVE S",
            "city": "MIDDLETOWN",
            "state": "RI",
            "postal_code": "028425421",
            "telephone_number": "401-847-5501"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "101 DUDLEY ST",
            "city": "PROVIDENCE",
            "state": "RI",
            "postal_code": "029052401",
            "telephone_number": "401-274-1100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CONNERTON",
        "first_name": "GINA",
        "middle_name": "M",
        "name_prefix": "Mrs.",
        "credential": "MLP-NP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2010-06-24",
        "last_updated": "2010-06-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LN0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Neonatal",
            "state": "RI",
            "license": "20010098",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Providence, RI

Sources for this page

Verify at the official NPI Registry.