Active NPI
Maureen Anne Connolly, M.D.
- Internal Medicine Physician
- Iowa City, IA
National Provider Identifier
1881745461
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Internal Medicine Physician
- License
- 27523
- Practice address
- 2460 Towncrest Dr
Iowa City, IA 52240-6622 - Phone
- (319) 338-7862
- Fax
- (319) 338-2517
- NPI assigned
- Jan 12, 2007
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Internal Medicine Physician | 207R00000X | 27523 | IA | Primary |
Addresses
Primary practice location
2460 Towncrest Dr
Iowa City, IA 52240-6622
Mailing address
2460 Towncrest Dr
Iowa City, IA 52240-6622
Phone (319) 338-7862
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0745877 | Medicaid | IA | |
| 32308 | Other | IA | WELLMARK |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
- Opted out of Medicare
- Yes, effective Jun 1, 2022 through Jun 1, 2028
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 27523 | IA | MD | Internal Medicine Physician |
Interoperability endpoints
- maureen.connolly@339595922767876.direct.elationemr.com
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1168560000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1192579200000",
"number": "1881745461",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2460 TOWNCREST DR",
"city": "IOWA CITY",
"state": "IA",
"postal_code": "522406622",
"telephone_number": "319-338-7862",
"fax_number": "319-338-2517"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2460 TOWNCREST DR",
"city": "IOWA CITY",
"state": "IA",
"postal_code": "522406622",
"telephone_number": "319-338-7862",
"fax_number": "319-338-2517"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CONNOLLY",
"first_name": "MAUREEN",
"middle_name": "ANNE",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-01-12",
"last_updated": "2007-10-17",
"status": "A"
},
"taxonomies": [
{
"code": "207R00000X",
"taxonomy_group": "",
"desc": "Internal Medicine",
"state": "IA",
"license": "27523",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "0745877",
"state": "IA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "WELLMARK",
"identifier": "32308",
"state": "IA"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Iowa City, IA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 17, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.