AMY G. CONNOLLY (NPI# 1033106331) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1033106331 |
| Entity Type | Individual |
| Full Name | AMY G. CONNOLLY |
| Credential | PA-C |
| Practice Address |
20400 W Warren Ave Detroit MI 48228-3242 |
| Mailing Address |
7348 Rafford Ln West Bloomfield MI 48322-3190 |
| Practice Telephone | 3132710500 |
| Practice Fax Number | 3132719313 |
| Mailing Telephone | 2485920733 |
| Enumeration Date | 2005-10-01 |
| Last Update Date | 2007-07-08 |
| Gender Code | F |
| Is Sole Proprietor | X |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363A00000X | Physician Assistant | 5601002695 | MI | Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| RAILROAD MEDICARE | P00191570 | 01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1023066214 | Amy Michelle Connolly | Counselor | 4424 Ne Glisan St, Portland, OR 97213-2331 | 2006-05-04 |
| 1275099608 | Amy Brook Connolly | Nurse Practitioner | 2700 Coltsgate Rd, Charlotte, NC 28211-3799 | 2019-02-11 |
| 1285076760 | Amy Connolly | Nurse Practitioner | 1000 Langworthy St, Dubuque, IA 52001-7313 | 2013-07-24 |
| 1700947595 | Amy C Connolly | Occupational Therapist | 801 Kings Hwy N, Fox Rehabilitation Services, Cherry Hill, NJ 08034-1513 | 2006-12-13 |
| Street Address |
20400 W WARREN AVE |
| City | DETROIT |
| State | MI |
| Zip Code | 48228-3242 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1124390331 | Stephanie Marie Workman | Registered Nurse | 20400 W Warren Ave, Detroit, MI 48228-3242 | 2012-02-02 |
| 1366659807 | Stout Family Medicine PC | Clinic/Center | 20400 W Warren Ave, Detroit, MI 48228-3242 | 2007-05-16 |
| 1104847847 | Perry J Olson | Physician Assistant | 20400 W Warren Ave, Detroit, MI 48228-3242 | 2006-07-21 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1932737210 | West Park Pharmacy LLC | Pharmacy | 16240 W Warren Ave, Detroit, MI 48228 | 2020-03-31 |
| 1316433329 | 4 Ur Recovery Therapy, LLC | Clinic/Center | 19201 Warren St, Detroit, MI 48228 | 2018-07-03 |
| 1003309063 | Marquita Outlaw | Registered Nurse | 8290 Coyle St, Detroit, MI 48228 | 2018-06-13 |
| 1043746548 | Am-pm Transportation Services LLC | Private Vehicle | 18640 Joy Road, Detroit, MI 48228 | 2017-05-04 |
| 1770023491 | Goodcompany Aop Inc | In Home Supportive Care | 8946 Prest St, Detroit, MI 48228 | 2017-02-28 |
| 1881049260 | Christine Jackson | Social Worker | 9115 Warwick, Detroit, MI 48228 | 2016-05-04 |
| 1790157774 | Shakail Bronta Hill | Adult Companion | 7729 Clayburn, Detroit, MI 48228 | 2015-10-29 |
| 1275904583 | Denarol Cunningham | Contractor | 7248 Vaughan, Detroit, MI 48228 | 2015-10-13 |
| 1023493210 | Larry Foster | Technician, Other | 9334 Memorial, Detroit, MI 48228 | 2015-07-29 |
| 1093126872 | Reza Hafezi | Chiropractor | 17600 W. Warren Ave., Detroit, MI 48228 | 2014-05-14 |
| Find all providers in zip 48228 | ||||
| Taxonomy Code | 363A00000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Physician Assistant |
| A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1619583994 | Isabella Lapuz Dela Cruz | Physician Assistant | 18463 Livernois Ave, Detroit, MI 48221-2254 | 2020-09-22 |
| 1932750684 | Patrick D Wharton | Physician Assistant | 5053 Commonwealth St # 1s, Detroit, MI 48208-2039 | 2019-09-24 |
| 1942869300 | Laura Dorothy Konsitzke | Physician Assistant | 22201 Moross Rd Ste 380, Detroit, MI 48236-2176 | 2019-06-10 |
| 1619419553 | Erica Ellen Schweitzer | Physician Assistant | 4701 Saint Antoine St Ste E-510, Detroit, MI 48201-1428 | 2016-11-09 |
| 1992167027 | Heather Michelle Sutton | Physician Assistant | 3901 Beaubien Drive, Detroit, MI 48201 | 2016-03-28 |
| 1659769107 | Zhi Li | Physician Assistant | 22201 Moross Rd Ste 370, Detroit, MI 48236 | 2015-01-07 |
| 1619371564 | Charlene Sharon Staff | Physician Assistant | 17701 Warwick St, Detroit, MI 48219-4210 | 2014-10-21 |
| 1245646025 | Sara Gibrael | Physician Assistant | 259 Mack Ave # 2590, Detroit, MI 48201-2427 | 2014-07-01 |
| 1497076434 | Mary Beth Morse | Physician Assistant | 4201 St. Antoine - Uhc 5d #226, University Pediatricians, Detroit, MI 48201-2153 | 2010-06-14 |
| 1265550487 | Claudine Lilla | Physician Assistant | 6071 W Outer Dr Dept Of, Detroit, MI 48235-2624 | 2007-03-26 |
| Find all providers in DETROIT | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.