Individual provider Active NPI

Brenda Lee Connolly, ARNP

  • Family Nurse Practitioner
  • Saint Petersburg, FL
National Provider Identifier
1790003689
Registry record updated Dec 22, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
ARNP 3359922 Issued in FL
Practice address
3501 54TH Ave S
Saint Petersburg, FL 33711-4541
Phone
(866) 389-2727
NPI assigned
May 17, 2010
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 22, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X ARNP 3359922 FL Primary

Addresses

Primary practice location

3501 54TH Ave S
Saint Petersburg, FL 33711-4541

Mailing address

3501 54TH Ave S
Saint Petersburg, FL 33711-4541
Phone (866) 389-2727

Other names 1

  • Mrs. Brenda Lee Neel Former name

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20130409000441 FL Practitioner - Nurse Practitioner 6204072630 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Minuteclinic LLCGroup PAC ID 6709850241, 576 clinicians

Practice addresses (Care Compare)

1 CVS Dr
Woonsocket, RI 02895-6146

1 CVS Drive- MC
Suite 3040
Woonsocket, RI 02895-6146

1000 E Tarpon Ave
Tarpon Springs, FL 34689-5438
Phone (866) 389-2727

30387 US Hwy 19 N
Clearwater, FL 33761-1053
Phone (866) 389-2727

3501 54TH Ave S
St Petersburg, FL 33711-4541
Phone (866) 389-2727

6206 Commerce Palms Dr
Tampa, FL 33647-1506
Phone (866) 389-2727

7599 W Sand Lake Rd
Orlando, FL 32819-5109
Phone (866) 389-2727

8001 9TH St N
Saint Petersburg, FL 33702-4109
Phone (866) 389-2727

8905 Bryan Dairy Rd
Largo, FL 33777-1102
Phone (866) 389-2727

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
ARNP 3359922FLMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Minuteclinic LLC Family CurrentSince Feb 25, 2013 Accepting new patients

Locations

121 W Macclenny Ave
Macclenny, FL 32063
Phone (904) 259-6380

7599 W Sand Lake Rd
Sand Lake, FL 32819
Phone (407) 352-0943

3501 54th Ave S
St Petersburg, FL 33711
Phone (727) 864-1546

8001 Mlk Jr Blvd N
St Petersburg, FL 33702
Phone (727) 577-6888

Networks

  • Healthfirst Medicare Network H1722
  • Healthfirst Medicare Network H3359
  • Healthfirst Medicare Network H5989
  • Healthfirst Medicare Network H9678

Organizations & group practices 1

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": "1274054400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1734825600000",
    "number": "1790003689",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3501 54TH AVE S",
            "city": "SAINT PETERSBURG",
            "state": "FL",
            "postal_code": "337114541",
            "telephone_number": "866-389-2727"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3501 54TH AVE S",
            "city": "SAINT PETERSBURG",
            "state": "FL",
            "postal_code": "337114541",
            "telephone_number": "866-389-2727"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CONNOLLY",
        "first_name": "BRENDA",
        "middle_name": "LEE",
        "name_prefix": "Mrs.",
        "credential": "ARNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-05-17",
        "last_updated": "2024-12-22",
        "certification_date": "2024-12-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "FL",
            "license": "ARNP 3359922",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "BRENDA",
            "last_name": "NEEL",
            "middle_name": "LEE",
            "prefix": "MRS.",
            "credential": "APRN",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Saint Petersburg, FL

Sources for this page

Verify at the official NPI Registry.