Theresa Conologue, DO

Primary specialty

Procedural Dermatology PhysicianTaxonomy code 207NS0135X

License

0102201892 Issued in VA

Practice address

1101 Sam Perry Blvd Ste 121
Fredericksburg, VA 22401-4465

Phone

(540) 899-1600

NPI assigned

Oct 4, 2006

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in VA, NC2 enrollments

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 2

Specialty

Dermatology

Education

Lake Erie College of Osteopathic Medicine, Erie, 2000

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Mary Washington Healthcare PhysiciansGroup PAC ID 2769546530, 286 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Mary Washington Hospital Hospital, Fredericksburg, VA, CCN 490022

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: tconologue12094@marywashingtonhealthcare.direct-ci.com

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.

• Mary Washington Healthcare Physicians

  • Family Medicine Physician
  • Fredericksburg, VA
  • NPI 1295999852
  Medicare reassignment Care Compare group NPD
• Outer Banks Dermatology

  • Dermatology Physician
  • Nags Head, NC
  • NPI 1912143462
  Medicare reassignment NPD
• Mary Washington Healthcare Physicians

  • Durable Medical Equipment & Medical Supplies
  • Fredericksburg, VA
  • NPI 1740853035
  NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Mary Washington Hospital Inc.

  • General Acute Care Hospital
  • Fredericksburg, VA
  • NPI 1942288527
  Care Compare affiliation
• Mary Washington Hospital, Inc.

  • Cardiovascular Disease Physician
  • Fredericksburg, VA
  • NPI 1013089879

  Hospital

  Care Compare affiliation
• Mary Washington Hospital, Inc.

  • Home Health Agency
  • Fredericksburg, VA
  • NPI 1407814163

  Hospital

  Care Compare affiliation

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

{
    "created_epoch": "1159920000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1367193600000",
    "number": "1053407452",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1101 SAM PERRY BLVD STE 121",
            "city": "FREDERICKSBURG",
            "state": "VA",
            "postal_code": "224014465",
            "telephone_number": "540-899-1600"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1101 SAM PERRY BLVD STE 121",
            "city": "FREDERICKSBURG",
            "state": "VA",
            "postal_code": "224014465",
            "telephone_number": "540-899-1600"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CONOLOGUE",
        "first_name": "THERESA",
        "name_prefix": "Dr.",
        "credential": "DO",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-10-04",
        "last_updated": "2013-04-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207NS0135X",
            "taxonomy_group": "",
            "desc": "Dermatology, Procedural Dermatology",
            "state": "VA",
            "license": "0102201892",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Concerted Care Group Fredericksburg LLC
• Confidential Counseling LLC
• Seth Conley
• Connect 2 Care Home Health LLC
• Caroline F Conneen, NP
• Barbara Conord, LPC
• Rebekah Adalyn Conrad, MSW
• Conscious Healing, Inc.
• Kostas Constantine, M.D.
• Consulting Connection Services LLC

• Procedural Dermatology Physician in Fredericksburg, VA
• Providers in Fredericksburg, VA by specialty
• Procedural Dermatology Physician in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 29, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.