Individual provider Active NPI

Nanita Jill Conner, FNP

  • Nurse Practitioner
  • Evansville, IN
National Provider Identifier
1770716912
Registry record updated Mar 7, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
71003017A Issued in IN
Practice address
421 Chestnut St
Evansville, IN 47713-1227
Phone
(812) 450-7466
Fax
(812) 450-4665
NPI assigned
Sep 3, 2009
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 7, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 71003017A IN
Nurse Practitioner 363L00000X 71003017A IN Primary

Addresses

Primary practice location

421 Chestnut St
Evansville, IN 47713-1227

Mailing address

PO Box 1510
Evansville, IN 47706-1510
Phone (812) 450-7466

Other identifiers 3

IdentifierTypeStateIssuer
200956810MedicaidIN
000000759066OtherANTHEM BCBS
7100104180MedicaidKY

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
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
I20251205002367 TX Practitioner - Nurse Practitioner 2466598438 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Doctors Express of the Beaumont Area PAGroup PAC ID 5698816882, 211 clinicians

Practice addresses (Care Compare)

3195 Dowlen Rd
Suite 105
Beaumont, TX 77706-7272
Phone (409) 860-1888

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Doctors Express of the Beaumont Area PA CurrentSince Oct 1, 2025 Accepting new patients
Owensboro Health Medical Group, Inc Nurse Practitioner Past Accepting new patients

Locations

8831 N Highway 146
Baytown, TX 77523
Phone (281) 533-8354

3195 Dowlen Rd
Ste 105
Beaumont, TX 77706
Phone (409) 860-1888

5568 Weslayan St
Houston, TX 77005
Phone (713) 666-7050

6445 FM 1463 Rd
Ste 230
Katy, TX 77494
Phone (281) 990-6890

8850 Spencer Hwy
La Porte, TX 77571
Phone (281) 946-9980

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1251936000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1678147200000",
    "number": "1770716912",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1510",
            "city": "EVANSVILLE",
            "state": "IN",
            "postal_code": "477061510",
            "telephone_number": "812-450-7466",
            "fax_number": "812-450-4665"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "421 CHESTNUT ST",
            "city": "EVANSVILLE",
            "state": "IN",
            "postal_code": "477131227",
            "telephone_number": "812-450-7466",
            "fax_number": "812-450-4665"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CONNER",
        "first_name": "NANITA",
        "middle_name": "JILL",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-09-03",
        "last_updated": "2023-03-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "IN",
            "license": "71003017A",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "IN",
            "license": "71003017A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200956810",
            "state": "IN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM BCBS",
            "identifier": "000000759066",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7100104180",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Evansville, IN

Sources for this page

Verify at the official NPI Registry.