Individual provider Active NPI

Carolyn Oneida O'Conner, FNP

  • Family Nurse Practitioner
  • Clarksdale, MS
National Provider Identifier
1841076403
Registry record updated Jun 25, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
906251 Issued in MS
Practice address
551 Medical Dr
Clarksdale, MS 38614-6733
Phone
(662) 624-2531
NPI assigned
Sep 7, 2023
Last updated
Jun 25, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 25, 2025

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 906251 MS Primary

Addresses

Primary practice location

551 Medical Dr
Clarksdale, MS 38614-6733

Mailing address

551 Medical Dr
Clarksdale, MS 38614-6733
Phone (662) 624-2531

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MS
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
I20231009002694 MS Practitioner - Nurse Practitioner 4981059144 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Delta Medical FoundationGroup PAC ID 2163777046, 8 clinicians

Practice addresses (Care Compare)

551 Medical Dr
Clarksdale, MS 38614-6733
Phone (662) 624-2531

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
906251MSMDRegistered Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
Delta Medical Foundation Current Accepting new patients
Delta Medical Foundation CurrentSince Aug 1, 2024 Accepting new patients
Tallahatchie General Hospital PastSince Sep 1, 2023 Accepting new patients
Tallahatchie General Hospital PastSince Jun 27, 2021 Accepting new patients

Locations

551 Medical Dr
Clarksdale, MS 38614
Phone (662) 624-2531

1024 Martin Luther King Dr
Marks, MS 38646
Phone (662) 326-3500

Interoperability endpoints

  • FHIR API: https://fhir-usa.unify.chbase.com/org/tallagh-438e232a

Organizations & group practices 4

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.

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1694044800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1750809600000",
    "number": "1841076403",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "551 MEDICAL DR",
            "city": "CLARKSDALE",
            "state": "MS",
            "postal_code": "386146733",
            "telephone_number": "662-624-2531"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "551 MEDICAL DR",
            "city": "CLARKSDALE",
            "state": "MS",
            "postal_code": "386146733",
            "telephone_number": "662-624-2531"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "O'CONNER",
        "first_name": "CAROLYN",
        "middle_name": "ONEIDA",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-09-07",
        "last_updated": "2025-06-25",
        "certification_date": "2025-06-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MS",
            "license": "906251",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Clarksdale, MS

Sources for this page

Verify at the official NPI Registry.