Organization Active NPI

Caroline Conner MD, Inc

  • Obstetrics & Gynecology Physician
  • Fountain Valley, CA
National Provider Identifier
1124351788
Registry record updated May 27, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X
License
A90651 Issued in CA
Legal business name
CAROLINE CONNER MD, INC
Practice address
9900 Talbert Ave
Suite 202
Fountain Valley, CA 92708-5153
Phone
(714) 378-5552
Fax
(714) 378-5541
NPI assigned
Sep 15, 2009
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 27, 2011

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

Authorized official

Name
Dr. Caroline Alana Conner, MDNPI 1538373725
Title
Physician
Phone
(714) 642-4514

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics & Gynecology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207V00000X A90651 CA Primary

Addresses

Primary practice location

9900 Talbert Ave
Suite 202
Fountain Valley, CA 92708-5153

Mailing address

9900 Talbert Ave
Suite 202
Fountain Valley, CA 92708-5153
Phone (714) 378-5552

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20100421000708 CA Part B Supplier - Clinic/Group Practice 8325175417 Receives reassigned benefits from 1 practitioner
Practice locations: Fountain Valley, CA

National Provider Directory

National Provider Directory

Locations

9900 Talbert Ave
#103A
Fountain Valley, CA 92708
Phone (714) 378-5005

9900 Talbert Ave
#202
Fountain Vly, CA 92708
Phone (714) 378-5552

Practitioners & affiliated clinicians

Practitioners 5

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1252972800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1306454400000",
    "number": "1124351788",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9900 TALBERT AVE",
            "address_2": "SUITE 202",
            "city": "FOUNTAIN VALLEY",
            "state": "CA",
            "postal_code": "927085153",
            "telephone_number": "714-378-5552",
            "fax_number": "714-378-5541"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9900 TALBERT AVE",
            "address_2": "SUITE 202",
            "city": "FOUNTAIN VALLEY",
            "state": "CA",
            "postal_code": "927085153",
            "telephone_number": "714-378-5552",
            "fax_number": "714-378-5541"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CAROLINE CONNER MD, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-09-15",
        "last_updated": "2011-05-27",
        "status": "A",
        "authorized_official_last_name": "CONNER",
        "authorized_official_first_name": "CAROLINE",
        "authorized_official_middle_name": "ALANA",
        "authorized_official_title_or_position": "PHYSICIAN",
        "authorized_official_telephone_number": "714-642-4514",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Obstetrics & Gynecology",
            "state": "CA",
            "license": "A90651",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fountain Valley, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 27, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.