Individual provider Active NPI

Jeanne O'Connell, M.D

  • Emergency Medicine Physician
  • Baltimore, MD
National Provider Identifier
1336185644
Registry record updated Apr 7, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
D0050484 Issued in MD
Practice address
22 S Greene St
Baltimore, MD 21201-1544
Phone
(410) 328-4383
NPI assigned
Jun 22, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 7, 2022

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 18245 WV
Emergency Medicine Physician 207P00000X D0050484 MD Primary

Addresses

Primary practice location

22 S Greene St
Baltimore, MD 21201-1544

Mailing address

PO Box 73276
Baltimore, MD 21273-3276
Phone (301) 631-8103

Other practice location 1

800 Wheeling Ave
Glen Dale, WV 26038-1660
Phone (304) 845-3211

Other practice location 2

3 E Benjamin Dr
New Martinsville, WV 26155-2705
Phone (304) 455-8000

Other identifiers 1

IdentifierTypeStateIssuer
543206500MedicaidMD

Electronic endpoints 3

TypeEndpointUseAffiliation
Direct Messaging Address joconnell212590@direct.wvuhsdirect.com Health Information Exchange (HIE)
Direct Messaging Address joconnell212590@direct.wvuhsdirect.com Health Information Exchange (HIE)
Direct Messaging Address joconnell212590@direct.wvuhsdirect.com Health Information Exchange (HIE)

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MD, WV2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20090623000263 MD Practitioner - Emergency Medicine 6800947474
I20200915002050 WV Practitioner - Emergency Medicine 6800947474

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
D0050484MDMDEmergency Medicine Physician
18245WVMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Frederick Health Hospital Inc Past Accepting new patients

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1150934400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1649289600000",
    "number": "1336185644",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 73276",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212733276",
            "telephone_number": "301-631-8103"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "22 S GREENE ST",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212011544",
            "telephone_number": "410-328-4383"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "800 Wheeling Ave",
            "address_purpose": "LOCATION",
            "city": "Glen Dale",
            "state": "WV",
            "postal_code": "260381660",
            "country_code": "US",
            "telephone_number": "304-845-3211",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "3 E Benjamin Dr",
            "address_purpose": "LOCATION",
            "city": "New Martinsville",
            "state": "WV",
            "postal_code": "261552705",
            "country_code": "US",
            "telephone_number": "304-455-8000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "O'CONNELL",
        "first_name": "JEANNE",
        "name_prefix": "Dr.",
        "credential": "M.D",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-06-22",
        "last_updated": "2022-04-07",
        "certification_date": "2022-04-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "WV",
            "license": "18245",
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "MD",
            "license": "D0050484",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "543206500",
            "state": "MD"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "joconnell212590@direct.wvuhsdirect.com",
            "affiliation": "N",
            "endpointDescription": "Direct Address",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "800 Wheeling Ave",
            "city": "Glen Dale",
            "state": "WV",
            "country_code": "US",
            "postal_code": "260381660",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "joconnell212590@direct.wvuhsdirect.com",
            "affiliation": "N",
            "endpointDescription": "Direct Address",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "800 Wheeling Ave",
            "city": "Glen Dale",
            "state": "WV",
            "country_code": "US",
            "postal_code": "260381660",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "joconnell212590@direct.wvuhsdirect.com",
            "affiliation": "N",
            "endpointDescription": "Direct Address",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "800 Wheeling Ave",
            "city": "Glen Dale",
            "state": "WV",
            "country_code": "US",
            "postal_code": "260381660",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Baltimore, MD

Sources for this page

Verify at the official NPI Registry.