Active NPI
Colleen Ann Connery
- Other Specialist/Technologist
- Lynn, MA
National Provider Identifier
1942923925
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Other Specialist/Technologist
- License
- BAPR20-0030
- Practice address
- Juli Moon Studio 9 Boston Street
Lynn, MA 01904 - Phone
- (781) 498-8282
- NPI assigned
- Sep 23, 2022
- Sex
- Female
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Other Specialist/Technologist | 246Z00000X | BAPR20-0030 | MA | Primary |
Addresses
Primary practice location
Juli Moon Studio 9 Boston Street
Lynn, MA 01904
Mailing address
9 Boston Street 2ND Floor
Lynn, MA 01904
Phone (978) 778-0110
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| BAPR20-0030 | MA | MD | Other Specialist/Technologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1663891200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1663891200000",
"number": "1942923925",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "9 BOSTON STREET 2ND FLOOR",
"city": "LYNN",
"state": "MA",
"postal_code": "01904",
"telephone_number": "978-778-0110"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "JULI MOON STUDIO 9 BOSTON STREET",
"city": "LYNN",
"state": "MA",
"postal_code": "01904",
"telephone_number": "781-498-8282"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CONNERY",
"first_name": "COLLEEN",
"middle_name": "ANN",
"name_prefix": "Miss",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2022-09-23",
"last_updated": "2022-09-23",
"certification_date": "2022-09-23",
"status": "A"
},
"taxonomies": [
{
"code": "246Z00000X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Specialist/Technologist, Other",
"state": "MA",
"license": "BAPR20-0030",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Lynn, MA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 23, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.