Andrew Conner, DPT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

62961 Issued in OR

Practice address

10915 SE Stark St
Portland, OR 97216-3348

Phone

(503) 261-1120

NPI assigned

Oct 19, 2018

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

Medicare fee-for-service enrollment

Enrolled in OR

Enrollment records 1

Specialty

Physical Therapist in Private Practice

Education

Other, 2017

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Oregon Sports Medicine AssociatesGroup PAC ID 1052306776, 17 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Oregon Sports Medicine Associates

  dba Sports Medicine Oregon

  • Specialist
  • Tigard, OR
  • NPI 1093713729
  Medicare reassignment Care Compare group
• North Lake Physical Therapy and Rehab LP

  • Physical Therapist
  • Lake Oswego, OR
  • NPI 1316383201
  Medicare reassignment NPD
• Pivot Health Acupuncture

  • Acupuncturist
  • Clackamas, OR
  • NPI 1184040255
  NPD

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

{
    "created_epoch": "1539907200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1539907200000",
    "number": "1326514035",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10915 SE STARK ST",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972163348",
            "telephone_number": "503-261-1120"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10915 SE STARK ST",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972163348",
            "telephone_number": "503-261-1120"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CONNER",
        "first_name": "ANDREW",
        "name_prefix": "Dr.",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-10-19",
        "last_updated": "2018-10-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "OR",
            "license": "62961",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jade Michelle Deck Connelly
• James Connelly, PHARMD
• Kara Jeanne Connelly, M.D.
• Kristen Connelly, MS, CF-SLP
• Alexandra Conner, PA
• Andrew Conner
• Carissa Camile Conner, LMT
• Erin Conner, MD
• Julie Melissa Conner, MS
• Taryn Michael Conner

• Physical Therapist in Portland, OR
• Providers in Portland, OR by specialty
• Physical Therapist in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 19, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.