Individual provider Active NPI

Connie K. Mercer, M.D.

  • Family Medicine Physician
  • Lady Lake, FL
National Provider Identifier
1730128034
Registry record updated Feb 6, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
ME69236 Issued in FL
Practice address
201 Lagrande Blvd
Lady Lake, FL 32159-1303
Phone
(352) 753-0606
Fax
(352) 753-0650
NPI assigned
Jun 5, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 6, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X ME69236 FL Primary

Addresses

Primary practice location

201 Lagrande Blvd
Lady Lake, FL 32159-1303

Mailing address

201 Lagrande Blvd
Lady Lake, FL 32159-1303
Phone (352) 753-0606

Other identifiers 2

IdentifierTypeStateIssuer
080112357OtherFLRAILROAD MEDICARE NUMBER
257176500MedicaidFL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20060111000235 FL Practitioner - Family Practice 7618990102 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
University of Iowa, RJ & L Carver College of Medicine, 1994
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Cora Health Services IncGroup PAC ID 1759290992, shared by 21 NPIs, 1,125 clinicians
Legacy Healthcare Services IncGroup PAC ID 2163339722, shared by 46 NPIs, 3,431 clinicians
Orlando Physicians Network IncGroup PAC ID 7719026251, 231 clinicians

Practice addresses (Care Compare)

1050 Old Camp Rd
Suite 282
The Villages, FL 32162-1762
Phone (352) 693-3378

1550 Killingsworth Way
The Villages, FL 32162-2175
Phone (352) 633-2971

201 Lagrande Blvd
Lady Lake, FL 32159-1303
Phone (352) 753-0606

8768 SE 165TH Mulberry LN
Cora Physical Therapy Mulberry Lane
The Villages, FL 32162-5861
Phone (352) 329-5237

Hospital & facility affiliations

  • Concierge Home Care Home health agency, The Villages, FL, CCN 108320
  • Florida Homecare Specialists Inc Home health agency, Lady Lake, FL, CCN 109071
  • Better @ Home Home health agency, The Villages, FL, CCN 108235
  • Rehab at Home Home health agency, Leesburg, FL, CCN 109503
  • Orlando Health South Lake Hospital Hospital, Clermont, FL, CCN 100051
  • Villages Regional Hospital, the Hospital, The Villages, FL, CCN 100290

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Orlando Physicians Network Inc Family Medicine CurrentSince Feb 1, 2023 Accepting new patients
Baycare Medical Group, Inc. Family Medicine PastSince Jul 1, 2022 Accepting new patients
Baycare Urgent Care, LLC Family Medicine Past Accepting new patients

Locations

1414 Kuhl Ave
#38
Orlando, FL 32806
Phone (407) 481-7179

21 Columbia St
Orlando, FL 32806
Phone (321) 841-5560

201 Lagrande Blvd
The Villages, FL 32159
Phone (352) 753-0606

Organizations & group practices 3

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.

Hospital & facility affiliations 7

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1149465600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1675641600000",
    "number": "1730128034",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "201 LAGRANDE BLVD",
            "city": "LADY LAKE",
            "state": "FL",
            "postal_code": "321591303",
            "telephone_number": "352-753-0606",
            "fax_number": "352-753-0650"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "201 LAGRANDE BLVD",
            "city": "LADY LAKE",
            "state": "FL",
            "postal_code": "321591303",
            "telephone_number": "352-753-0606",
            "fax_number": "352-753-0650"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MERCER",
        "first_name": "CONNIE",
        "middle_name": "K.",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-06-05",
        "last_updated": "2023-02-06",
        "certification_date": "2023-02-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "FL",
            "license": "ME69236",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE NUMBER",
            "identifier": "080112357",
            "state": "FL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "257176500",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Lady Lake, FL

Sources for this page

Verify at the official NPI Registry.