Individual provider Active NPI

Leo Shannon O'Connor, NP

  • Adult Health Nurse Practitioner
  • Carmel, IN
National Provider Identifier
1770851610
Registry record updated Jan 6, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Health Nurse PractitionerTaxonomy code 363LA2200X
License
28129315A Issued in IN
Practice address
11455 N Meridian St
200
Carmel, IN 46032-1624
Phone
(317) 582-8180
Fax
(317) 582-8182
NPI assigned
Dec 7, 2011
Last updated
Jan 6, 2012By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 6, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Health Nurse Practitioner 363LA2200X 28129315A IN Primary

Addresses

Primary practice location

11455 N Meridian St
200
Carmel, IN 46032-1624

Mailing address

12302 Hancock St
Carmel, IN 46032-5807
Phone (317) 564-4836

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)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
28129315AINMDAdult Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Union Healthcare Services Inc PastSince Feb 9, 2020 Accepting new patients
House Calls Medical Solutions, LLC PastSince Apr 1, 2011 Accepting new patients

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, 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": "1323216000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1325808000000",
    "number": "1770851610",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12302 HANCOCK ST",
            "city": "CARMEL",
            "state": "IN",
            "postal_code": "460325807",
            "telephone_number": "317-564-4836",
            "fax_number": "317-587-2341"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11455 N MERIDIAN ST",
            "address_2": "200",
            "city": "CARMEL",
            "state": "IN",
            "postal_code": "460321624",
            "telephone_number": "317-582-8180",
            "fax_number": "317-582-8182"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "O'CONNOR",
        "first_name": "LEO",
        "middle_name": "SHANNON",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-12-07",
        "last_updated": "2012-01-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "IN",
            "license": "28129315A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Carmel, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 6, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.