Individual provider Active NPI

David Connor, M.D.

  • Emergency Medicine Physician
  • Glendale, AZ
National Provider Identifier
1003848227
Registry record updated Oct 18, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
22502 Issued in AZ
Practice address
5555 W Thunderbird Rd
Glendale, AZ 85306-4622
Phone
(602) 588-5555
NPI assigned
Jul 7, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 18, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X 22502 AZ Primary

Addresses

Primary practice location

5555 W Thunderbird Rd
Glendale, AZ 85306-4622

Mailing address

2000 Spring Rd
Suite 200
Oak Brook, IL 60523-1804
Phone (630) 472-8800

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AZ
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.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100820000806 AZ Practitioner - Emergency Medicine 0941103170 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
22502AZMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
North Valley Emergency Specialists Emergency Medicine CurrentSince Oct 1, 2002 Accepting new patients
Team Physicians of Arizona PC Emergency Medicine Past Accepting new patients

Locations

5555 W Thunderbird Rd
Glendale, AZ 85306
Phone (602) 588-5555

2000 Spring Rd
Ste 200
Oak Brook, IL 60523
Phone (630) 472-8810

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": "1152230400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1192665600000",
    "number": "1003848227",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2000 SPRING RD",
            "address_2": "SUITE 200",
            "city": "OAK BROOK",
            "state": "IL",
            "postal_code": "605231804",
            "telephone_number": "630-472-8800"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5555 W THUNDERBIRD RD",
            "city": "GLENDALE",
            "state": "AZ",
            "postal_code": "853064622",
            "telephone_number": "602-588-5555"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CONNOR",
        "first_name": "DAVID",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-07-07",
        "last_updated": "2007-10-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "AZ",
            "license": "22502",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Glendale, AZ

Sources for this page

Verify at the official NPI Registry.