Active NPI
Cameron Mitchell Connolly, DO
- Student in an Organized Health Care Education/Training Program
- Conroe, TX
National Provider Identifier
1144089426
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Student in an Organized Health Care Education/Training Program
- Practice address
- 925 Central City Avenue
Conroe, TX 77304 - Phone
- (832) 474-5476
- NPI assigned
- Mar 18, 2024
- Sex
- Male
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Student in an Organized Health Care Education/Training Program | 390200000X | Primary |
Addresses
Primary practice location
925 Central City Avenue
Conroe, TX 77304
Mailing address
7318 Flagship Park Dr
Jonestown, TX 78645-4494
Phone (832) 474-5476
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Doctor of Osteopathy
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1710720000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1710720000000",
"number": "1144089426",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "7318 FLAGSHIP PARK DR",
"city": "JONESTOWN",
"state": "TX",
"postal_code": "786454494",
"telephone_number": "832-474-5476"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "925 CENTRAL CITY AVENUE",
"city": "CONROE",
"state": "TX",
"postal_code": "77304",
"telephone_number": "832-474-5476"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CONNOLLY",
"first_name": "CAMERON",
"middle_name": "MITCHELL",
"credential": "DO",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2024-03-18",
"last_updated": "2024-03-18",
"certification_date": "2024-03-16",
"status": "A"
},
"taxonomies": [
{
"code": "390200000X",
"taxonomy_group": "",
"desc": "Student in an Organized Health Care Education/Training Program",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Conroe, TX
- Compassionate Care Hospice of Southeastern TX, LLC (Amedisys Hospice)
- Compassionate Care Senior Living
- Comprehnesive Assessment and Counsleing Connections (Assessment and Counseling Connectrions)
- Concheso & Priede Family Medicine, PLLC
- John W Conley, LPC
- Conore Oral Care PC
- Conroe Advanced Dentistry, PLLC (Conroe Advanced Dentistry)
- Conroe Ambulatory Anesthesia PA
- Conroe Assisted Living, LTD. (Hearthstone at Rivershire)
- Conroe Clinic Corporation (MediClinic Conroe)
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 18, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.