Individual provider Active NPI

Mary Connor

  • Family Nurse Practitioner
  • Minneapolis, MN
National Provider Identifier
1972774065
Registry record updated Dec 31, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
SP009685 Issued in PA
Practice address
920 2ND Ave S
Suite 400
Minneapolis, MN 55402-3318
Phone
(612) 225-1534
NPI assigned
Mar 17, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 31, 2008

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 SP009685 PA Primary

Addresses

Primary practice location

920 2ND Ave S
Suite 400
Minneapolis, MN 55402-3318

Mailing address

920 2ND Ave S
Suite 400
Minneapolis, MN 55402-3318
Phone (612) 225-1534

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA
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
I20080410000051 PA Practitioner - Nurse Practitioner 8921185349 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2007
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Jefferson University PhysiciansGroup PAC ID 7911819180, 1,528 clinicians

Practice addresses (Care Compare)

25 S 9TH St
1St Floor
Philadelphia, PA 19107-4408
Phone (215) 955-1200

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
SP009685PAMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Jefferson University Physicians CurrentSince Apr 1, 2020 Accepting new patients
Jefferson University Physicians Past Accepting new patients

Locations

25 S 9th St
Fl 1
Philadelphia, PA 19107
Phone (215) 955-1200

925 Chestnut St
Fl 6
Philadelphia, PA 19107
Phone (215) 955-6760

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1205712000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1230681600000",
    "number": "1972774065",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "920 2ND AVE S",
            "address_2": "SUITE 400",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554023318",
            "telephone_number": "612-225-1534"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "920 2ND AVE S",
            "address_2": "SUITE 400",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554023318",
            "telephone_number": "612-225-1534"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CONNOR",
        "first_name": "MARY",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-03-17",
        "last_updated": "2008-12-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "PA",
            "license": "SP009685",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Minneapolis, MN

Sources for this page

Verify at the official NPI Registry.