Individual provider Active NPI

Connor Simon, NP

  • Family Nurse Practitioner
  • Baton Rouge, LA
National Provider Identifier
1962395988
Registry record updated Jun 24, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
213556 Issued in LA
Practice address
7777 Hennessy Blvd Ste 206
Baton Rouge, LA 70808-4363
Phone
(225) 767-1156
Fax
(225) 767-5980
NPI assigned
May 29, 2025
Sex
Unspecified or another gender identity
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 24, 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 213556 LA Primary

Addresses

Primary practice location

7777 Hennessy Blvd Ste 206
Baton Rouge, LA 70808-4363

Mailing address

5959 S Sherwood Forest Blvd
Baton Rouge, LA 70816-6038
Phone (225) 767-1156

Other practice location 1

5000 Hennessy Blvd
Baton Rouge, LA 70808-4375
Phone (225) 765-6565

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in LA
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
I20250805001569 LA Practitioner - Nurse Practitioner 2466960083 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Our Lady of the Lake Physician Group LLCGroup PAC ID 4587849781, 637 clinicians

Practice addresses (Care Compare)

7777 Hennessy Blvd
Suite 206
Baton Rouge, LA 70808-4363
Phone (225) 767-1156

Hospital & facility affiliations

  • Our Lady of the Lake Regional Medical Center Hospital, Baton Rouge, LA, CCN 190064

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Our Lady of the Lake Physician Group LLC CurrentSince Jul 13, 2025 Accepting new patients
Our Lady of the Lake Physician Group LLC Nurse Practitioner CurrentSince Jul 13, 2025 Accepting new patients
Baton Rouge Colon Rectal Associates PastSince Jun 29, 2025 Accepting new patients
Our Lady of the Lake Physician Group LLC Nurse Practitioner Past Accepting new patients

Locations

5959 S Sherwood Forest Blvd
Baton Rouge, LA 70816
Phone (225) 526-0011

5000 Hennessy Blvd
Baton Rouge, LA 70808
Phone (225) 765-4050

5000 Odonavan Blvd
Ste 404
Walker, LA 70785
Phone (225) 369-8100

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 and National Provider Directory roles.

Hospital & facility affiliations 1

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": "1748476800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1750723200000",
    "number": "1962395988",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5959 S SHERWOOD FOREST BLVD",
            "city": "BATON ROUGE",
            "state": "LA",
            "postal_code": "708166038",
            "telephone_number": "225-767-1156",
            "fax_number": "225-765-9196"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7777 HENNESSY BLVD STE 206",
            "city": "BATON ROUGE",
            "state": "LA",
            "postal_code": "708084363",
            "telephone_number": "225-767-1156",
            "fax_number": "225-767-5980"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5000 Hennessy Blvd",
            "address_purpose": "LOCATION",
            "city": "Baton Rouge",
            "state": "LA",
            "postal_code": "708084375",
            "country_code": "US",
            "telephone_number": "225-765-6565",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SIMON",
        "first_name": "CONNOR",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "X",
        "enumeration_date": "2025-05-29",
        "last_updated": "2025-06-24",
        "certification_date": "2025-06-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "LA",
            "license": "213556",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Baton Rouge, LA

Sources for this page

Verify at the official NPI Registry.