Kevin J. Connolly, M.D.

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

0420009101 Issued in VT

Practice address

437 S Main St
Bradford, VT 05033-8877

Phone

(802) 222-5562

NPI assigned

Jun 13, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Interoperability endpoints

• Direct secure messaging: kconnolly@yourcarecommunity.org

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

{
    "created_epoch": "1150156800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1281916800000",
    "number": "1124061650",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "P O BOX 318",
            "city": "BRADFORD",
            "state": "VT",
            "postal_code": "050330338",
            "telephone_number": "802-222-5562",
            "fax_number": "802-222-9276"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "437 S MAIN ST",
            "city": "BRADFORD",
            "state": "VT",
            "postal_code": "050338877",
            "telephone_number": "802-222-5562"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CONNOLLY",
        "first_name": "KEVIN",
        "middle_name": "J.",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-13",
        "last_updated": "2010-08-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "VT",
            "license": "0420009101",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAIL ROAD MEDICARE",
            "identifier": "110105365",
            "state": "VT"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "OVN1126",
            "state": "VT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Lora Oakes Chatfield, CNM
• Margarethe M Chobanian, M.D.
• Jennifer April Civiello, CPNP
• Robert William Claflin, LCMHC
• Thomas Clark, MD
• Hilary Watts Coons, PHD
• Tanya Rebekah Croke, LISCW
• Ctr Therapy LLC
• Ellen Dahill-Brown, MA
• Danielle Drown, MA

• Family Medicine Physician in Bradford, VT
• Providers in Bradford, VT by specialty
• Family Medicine Physician in Vermont

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 16, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.