Active NPI
Guy A O'Connor, M.D.
- Emergency Medicine Physician
- Manitowoc, WI
National Provider Identifier
1144333519
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Emergency Medicine Physician
- License
- 26328-020
- Practice address
- 2300 Western Ave
Manitowoc, WI 54220-3712 - Phone
- (920) 320-2011
- NPI assigned
- Aug 17, 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 |
|---|---|---|---|---|
| Emergency Medicine Physician | 207P00000X | 26328-020 | WI | Primary |
Addresses
Primary practice location
2300 Western Ave
Manitowoc, WI 54220-3712
Mailing address
PO Box 1596
Manitowoc, WI 54221-1596
Phone (920) 320-3097
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| P00099737 | Other | WI | MEDICARE RAILROAD |
| 34427400 | Medicaid | WI |
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)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 26328-020 | WI | MD | Emergency Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Holy Family Memorial Inc | Past | Accepting new patients | |
| Tri-City Express Care, PLLC | Family Medicine | Past | Accepting new patients |
Organizations & group practices 2
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.
-
- General Acute Care Hospital
- Manitowoc, WI
- NPI 1700998697
-
- Family Medicine Physician
- Mesa, AZ
- NPI 1649554940
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1155772800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1309305600000",
"number": "1144333519",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 1596",
"city": "MANITOWOC",
"state": "WI",
"postal_code": "542211596",
"telephone_number": "920-320-3097",
"fax_number": "920-320-3529"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2300 WESTERN AVE",
"city": "MANITOWOC",
"state": "WI",
"postal_code": "542203712",
"telephone_number": "920-320-2011"
}
],
"practiceLocations": [],
"basic": {
"last_name": "O'CONNOR",
"first_name": "GUY",
"middle_name": "A",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-08-17",
"last_updated": "2011-06-29",
"status": "A"
},
"taxonomies": [
{
"code": "207P00000X",
"taxonomy_group": "",
"desc": "Emergency Medicine",
"state": "WI",
"license": "26328-020",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDICARE RAILROAD",
"identifier": "P00099737",
"state": "WI"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "34427400",
"state": "WI"
}
],
"endpoints": [],
"other_names": []
}Other providers in Manitowoc, WI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 29, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.