Gregory Connolly, MD

Primary specialty

Pediatric Adolescent Medicine PhysicianTaxonomy code 2080A0000X

License

042-0011956 Issued in VT

Practice address

128 Lakeside Ave
Suite 115
Burlington, VT 05401-4939

Phone

(802) 860-1928

Fax

(802) 860-0192

NPI assigned

Jul 12, 2007

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

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

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.

• University of Vermont Medical Center Inc

  • General Acute Care Hospital
  • Burlington, VT
  • NPI 1568419976
  NPD (past)

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

{
    "created_epoch": "1184198400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1380844800000",
    "number": "1366641086",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "128 LAKESIDE AVE",
            "address_2": "SUITE 115",
            "city": "BURLINGTON",
            "state": "VT",
            "postal_code": "054014939",
            "telephone_number": "802-860-1928",
            "fax_number": "802-860-0192"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "128 LAKESIDE AVE",
            "address_2": "SUITE 115",
            "city": "BURLINGTON",
            "state": "VT",
            "postal_code": "054014939",
            "telephone_number": "802-860-1928",
            "fax_number": "802-860-0192"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CONNOLLY",
        "first_name": "GREGORY",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-07-12",
        "last_updated": "2013-10-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2080A0000X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Adolescent Medicine",
            "state": "VT",
            "license": "042-0011956",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1017604",
            "state": "VT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Anne Margaret Condon, LCMHC, LADC
• Catherine Cone
• Beach Conger, MD
• Sasha Conley
• Taylor Conlon
• Leslie McCoy Conroy, M.D.
• Hayley Contois
• James Stephen Contompasis, MD
• Mary Contompasis, OT
• Stephen Contompasis, M.D.

• Pediatric Adolescent Medicine Physician in Burlington, VT
• Providers in Burlington, VT by specialty
• Pediatric Adolescent Medicine Physician in Vermont

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 4, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.