Individual provider Active NPI

Kevin Conn, M.D.

  • Emergency Medicine Physician
  • Flagstaff, AZ
National Provider Identifier
1104995638
Registry record updated Aug 30, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
27728 Issued in AZ
Practice address
1200 N Beaver St
Flagstaff, AZ 86001-3118
Phone
(928) 380-0476
Fax
(928) 214-3882
NPI assigned
Nov 7, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 30, 2016

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 27728 AZ Primary

Addresses

Primary practice location

1200 N Beaver St
Flagstaff, AZ 86001-3118

Mailing address

1600 W University Ave
Ste 215
Flagstaff, AZ 86001-3115
Phone (928) 774-1693

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
I20111118000044 AZ Practitioner - Emergency Medicine 1254467855 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Emergency Medicine
Education
University of Arizona College of Medicine, 2000
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Flagstaff Emergency PhysiciansGroup PAC ID 2860380813, 43 clinicians

Practice addresses (Care Compare)

1200 N Beaver St
Flagstaff, AZ 86001-3118
Phone (928) 774-1693

Hospital & facility affiliations

  • Verde Valley Medical Center Hospital, Cottonwood, AZ, CCN 030007

Merit-based Incentive Payment System (MIPS)

Final score
76.21 of 100Reported as group
Quality
70.63
Improvement activities
40

Merit-based Incentive Payment System (MIPS)

Final score
82.13 of 100Reported as group
Quality
66.85
Promoting interoperability
99
Improvement activities
40
Cost
74.4

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
27728AZMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Flagstaff Emergency Physicians Emergency Medicine CurrentSince Jul 1, 2002 Accepting new patients

Locations

269 S Candy Ln
Cottonwood, AZ 86326
Phone (928) 634-2251

1600 W University Ave
Ste 215
Flagstaff, AZ 86001
Phone (928) 214-3930

1200 N Beaver St
Flagstaff, AZ 86001
Phone (928) 213-6235

3700 W State Route 89A
Sedona, AZ 86336
Phone (928) 204-3000

Organizations & group practices 1

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.

Hospital & facility affiliations 2

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

NPI Registry JSON

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

{
    "created_epoch": "1162857600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1472515200000",
    "number": "1104995638",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1600 W UNIVERSITY AVE",
            "address_2": "STE 215",
            "city": "FLAGSTAFF",
            "state": "AZ",
            "postal_code": "860013115",
            "telephone_number": "928-774-1693",
            "fax_number": "928-774-3533"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1200 N BEAVER ST",
            "city": "FLAGSTAFF",
            "state": "AZ",
            "postal_code": "860013118",
            "telephone_number": "928-380-0476",
            "fax_number": "928-214-3882"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CONN",
        "first_name": "KEVIN",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-11-07",
        "last_updated": "2016-08-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "AZ",
            "license": "27728",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Flagstaff, AZ

Sources for this page

Verify at the official NPI Registry.