NPIMap

Individual provider Active NPI

John C O'Connor, M.D.

  • Sports Medicine (Family Medicine) Physician
  • Bellefontaine, OH
National Provider Identifier
1184600512
Registry record updated Feb 19, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Sports Medicine (Family Medicine) PhysicianTaxonomy code 207QS0010X
License
35-067068 Issued in OH
Practice address
2211 Timber TRL
Bellefontaine, OH 43311-9036
Phone
(937) 592-3808
Fax
(937) 593-8404
NPI assigned
Dec 19, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 19, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X 35.067068 OH
Sports Medicine (Family Medicine) Physician 207QS0010X 35-067068 OH Primary

Addresses

Primary practice location

2211 Timber TRL
Bellefontaine, OH 43311-9036

Mailing address

2211 Timber TRL
Bellefontaine, OH 43311-9036
Phone (937) 592-3808

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040324000838 OH Practitioner - Emergency MedicinePractitioner - Family Practice 6204723398 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family PracticeAlso: Emergency Medicine
Education
University of Toledo College of Medicine, 1993
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Emergency Professional Services, Inc.Group PAC ID 7214832435, 121 clinicians
Maple Leaf Family and Sports Medicine, LLCGroup PAC ID 7416844592, 4 clinicians

Practice addresses (Care Compare)

205 Palmer Ave
Bellefontaine, OH 43311
Phone (937) 592-4015

2211 Timber TRL
Bellefontaine, OH 43311-9036
Phone (937) 592-3808

Hospital & facility affiliations

  • Otterbein Universal Home Health & Hospice Home health agency, Bellefontaine, OH, CCN 367404
  • High Point Home Health, LTD Home health agency, Bellefontaine, OH, CCN 367798
  • Mary Rutan Hospital Hospital, Bellefontaine, OH, CCN 360197
  • Memorial Hospital Hospital, Marysville, OH, CCN 360092
  • Hardin Memorial Hospital Hospital, Kenton, OH, CCN 361315
  • Mercy Health St Ritas Medical Center Hospital, Lima, OH, CCN 360066
  • Ohio State University State Health System Hospital, Columbus, OH, CCN 360085

Merit-based Incentive Payment System (MIPS)

Final score
85.5 of 100Reported as apm
Quality
71.52
Promoting interoperability
95.57
Improvement activities
40

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions1-10
Removal or shaving of skin growth1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
35.067068OHMDEmergency Medicine Physician
35-067068OHMDSports Medicine (Family Medicine) Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Maple Leaf Family and Sports Medicine, LLC Sports Medicine CurrentSince Jan 1, 2001 Accepting new patients
Emergency Professional Services, Inc. Emergency Medicine CurrentSince Apr 1, 2016 Accepting new patients
Mary Rutan Hospital Past Accepting new patients
Lima Memorial Joint Operating Company Past Accepting new patients

Locations

205 E Palmer Rd
Bellefontaine, OH 43311
Phone (937) 592-4015

2211 Timber Trl
Bellefontaine, OH 43311
Phone (937) 592-3808

921 E Franklin St
Kenton, OH 43326
Phone (419) 673-0761

18697 Bagley Rd
Middleburg Heights, OH 44130
Phone (440) 816-8000

Interoperability endpoints

  • Direct secure messaging: john.oconnor@mlfsm.eclinicaldirectplus.com
  • FHIR API: https://fhir4.healow.com/fhir/r4/JAAAAA

Organizations & group practices 4

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 10

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": "1134950400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1739923200000",
    "number": "1184600512",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2211 TIMBER TRL",
            "city": "BELLEFONTAINE",
            "state": "OH",
            "postal_code": "433119036",
            "telephone_number": "937-592-3808",
            "fax_number": "937-593-8404"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2211 TIMBER TRL",
            "city": "BELLEFONTAINE",
            "state": "OH",
            "postal_code": "433119036",
            "telephone_number": "937-592-3808",
            "fax_number": "937-593-8404"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "O'CONNOR",
        "first_name": "JOHN",
        "middle_name": "C",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-12-19",
        "last_updated": "2025-02-19",
        "certification_date": "2025-02-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "OH",
            "license": "35.067068",
            "primary": false
        },
        {
            "code": "207QS0010X",
            "taxonomy_group": "",
            "desc": "Family Medicine, Sports Medicine",
            "state": "OH",
            "license": "35-067068",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bellefontaine, OH

Sources for this page

Verify at the official NPI Registry.