Active NPI
Connell Covington, M.D.
- Pediatric Adolescent Medicine Physician
- Raleigh, NC
National Provider Identifier
1104885938
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatric Adolescent Medicine Physician
- License
- 22696
- Practice address
- 3350 Six Forks Rd
Raleigh, NC 27609-7233 - Phone
- (919) 881-9440
- Fax
- (919) 881-9465
- NPI assigned
- Mar 21, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatric Adolescent Medicine Physician | 2080A0000X | 22696 | NC | Primary |
Addresses
Primary practice location
3350 Six Forks Rd
Raleigh, NC 27609-7233
Mailing address
7413 Six Forks Rd # 307
Raleigh, NC 27615-6164
Phone (919) 881-9440
Other identifiers 5
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1206226 | Other | NC | UNITED HEALTHCARE |
| 1539139 | Other | NC | CIGNA |
| 4209043 | Other | NC | AETNA |
| 8924752 | Medicaid | NC | |
| 24752 | Other | NC | BLUE CROSS BLUE SHIELD |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in NC
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20221117000965 | NC | Order and Referring Only - Pediatric Medicine | 9335517630 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1142899200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1668470400000",
"number": "1104885938",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "7413 SIX FORKS RD # 307",
"city": "RALEIGH",
"state": "NC",
"postal_code": "276156164",
"telephone_number": "919-881-9440",
"fax_number": "919-881-9465"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3350 SIX FORKS RD",
"city": "RALEIGH",
"state": "NC",
"postal_code": "276097233",
"telephone_number": "919-881-9440",
"fax_number": "919-881-9465"
}
],
"practiceLocations": [],
"basic": {
"last_name": "COVINGTON",
"first_name": "CONNELL",
"name_prefix": "Mr.",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-03-21",
"last_updated": "2022-11-15",
"certification_date": "2022-11-15",
"status": "A"
},
"taxonomies": [
{
"code": "2080A0000X",
"taxonomy_group": "",
"desc": "Pediatrics, Adolescent Medicine",
"state": "NC",
"license": "22696",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "UNITED HEALTHCARE",
"identifier": "1206226",
"state": "NC"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "CIGNA",
"identifier": "1539139",
"state": "NC"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "AETNA",
"identifier": "4209043",
"state": "NC"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "8924752",
"state": "NC"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE CROSS BLUE SHIELD",
"identifier": "24752",
"state": "NC"
}
],
"endpoints": [],
"other_names": []
}Other providers in Raleigh, NC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 15, 2022; 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.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.