Active NPI
Jane F. Connelly, AU.D. CCC-A
- Audiologist
- Saint Paul, MN
National Provider Identifier
1750528824
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Audiologist
- License
- 5330
- Practice address
- 560 Concordia Ave
Rondo Ecse
Saint Paul, MN 55103-2443 - Phone
- (651) 325-2699
- Fax
- (651) 325-2691
- NPI assigned
- Jan 12, 2009
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Audiologist | 231H00000X | 5330 | MN | Primary |
Addresses
Primary practice location
560 Concordia Ave
Rondo Ecse
Saint Paul, MN 55103-2443
Mailing address
430 Wildwood Ave
Saint Paul, MN 55110-1619
Phone (651) 426-7658
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 5330 | MN | MD | Clinical Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1231718400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1231718400000",
"number": "1750528824",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "430 WILDWOOD AVE",
"city": "SAINT PAUL",
"state": "MN",
"postal_code": "551101619",
"telephone_number": "651-426-7658"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "560 CONCORDIA AVE",
"address_2": "RONDO ECSE",
"city": "SAINT PAUL",
"state": "MN",
"postal_code": "551032443",
"telephone_number": "651-325-2699",
"fax_number": "651-325-2691"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CONNELLY",
"first_name": "JANE",
"middle_name": "F.",
"credential": "AU.D. CCC-A",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2009-01-12",
"last_updated": "2009-01-12",
"status": "A"
},
"taxonomies": [
{
"code": "231H00000X",
"taxonomy_group": "",
"desc": "Audiologist",
"state": "MN",
"license": "5330",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Saint Paul, MN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 12, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.