Individual provider Active NPI

Maureen Anne Connolly, M.D.

  • Internal Medicine Physician
  • Iowa City, IA
National Provider Identifier
1881745461
Registry record updated Oct 17, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
27523 Issued in IA
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

Updated by the provider on Oct 17, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
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

IdentifierTypeStateIssuer
0745877MedicaidIA
32308OtherIAWELLMARK

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
Green means eligible to order or refer.
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

LicenseStateTypeSpecialty
27523IAMDInternal Medicine Physician

Interoperability endpoints

  • Direct secure messaging: 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

Verify at the official NPI Registry.