Organization Active NPI

Connection Psychiatry, PLLC

  • Psychiatric/Mental Health Nurse Practitioner
  • Bloomington, IL
National Provider Identifier
1780263384
Registry record updated Feb 23, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
Legal business name
CONNECTION PSYCHIATRY, PLLC
Practice address
1709 Jumer Dr
Bloomington, IL 61704-0914
Phone
(309) 463-5800
Fax
(833) 914-2704
NPI assigned
Apr 2, 2021
Last updated
Feb 23, 2026By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 23, 2026

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

Authorized official

Name
Melinda Roth, APNNPI 1154757045
Title
Owner
Phone
(815) 343-9382

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse PractitionerGroup: 193400000X SINGLE SPECIALTY GROUP 363LP0808X Primary

Addresses

Primary practice location

1709 Jumer Dr
Bloomington, IL 61704-0914

Mailing address

1709 Jumer Dr
Bloomington, IL 61704-0914
Phone (309) 463-5800

Electronic endpoints 1

TypeEndpointUseAffiliation
CONNECT URL www.connectionpsychiatry.com Direct

National Provider Directory

National Provider Directory

Locations

1100 Beech St
Bldg 10
Normal, IL 61761
Phone (309) 463-5800

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1617321600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1771804800000",
    "number": "1780263384",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1709 JUMER DR",
            "city": "BLOOMINGTON",
            "state": "IL",
            "postal_code": "617040914",
            "telephone_number": "309-463-5800",
            "fax_number": "833-914-2704"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1709 JUMER DR",
            "city": "BLOOMINGTON",
            "state": "IL",
            "postal_code": "617040914",
            "telephone_number": "309-463-5800",
            "fax_number": "833-914-2704"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CONNECTION PSYCHIATRY, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-04-02",
        "last_updated": "2026-02-23",
        "certification_date": "2026-02-23",
        "status": "A",
        "authorized_official_last_name": "ROTH",
        "authorized_official_first_name": "MELINDA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "815-343-9382",
        "authorized_official_credential": "APN"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "www.connectionpsychiatry.com",
            "affiliation": "N",
            "endpointDescription": "Location URL",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "1100 Beech St Bldg 10",
            "city": "Normal",
            "state": "IL",
            "country_code": "US",
            "postal_code": "617611493",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Bloomington, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 23, 2026; 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.