Connor Paul Donaldson, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

Practice address

2751 Albert L Bicknell Dr
Shreveport, LA 71103-3920

Phone

(318) 212-4275

NPI assigned

Sep 13, 2023

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 LA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Physician Assistant

Education

Other, 2023

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Professional Pediatrics, LLCGroup PAC ID 5698847317, 5 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Byrd Regional Hospital Hospital, Leesville, LA, CCN 190164

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

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.

• Professional Pediatrics, LLC

  • Rural Health Clinic/Center
  • Leesville, LA
  • NPI 1376717959
  Medicare reassignment Care Compare group

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• CLHG-Leesville

  • General Acute Care Hospital
  • Leesville, LA
  • NPI 1881665164
  Care Compare affiliation

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

{
    "created_epoch": "1694563200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1694563200000",
    "number": "1396522298",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9000 W WILDERNESS WAY APT 243",
            "city": "SHREVEPORT",
            "state": "LA",
            "postal_code": "711066837",
            "telephone_number": "337-718-8262"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2751 ALBERT L BICKNELL DR",
            "city": "SHREVEPORT",
            "state": "LA",
            "postal_code": "711033920",
            "telephone_number": "318-212-4275"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DONALDSON",
        "first_name": "CONNOR",
        "middle_name": "PAUL",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2023-09-13",
        "last_updated": "2023-09-13",
        "certification_date": "2023-09-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Anibal Dominguez, MD
• Maria Hoeller Dominguez, M.D.
• Keshana Dominique
• Sanae Dominique
• Donald G Mack Sr MD and Willis-Knighton Medical Center
• Jasmine Donatto
• Kimberly Donelson, CPNP
• Suresh Kumar Donepudi, MD
• Caiping Dong, MD
• Deanna S. Donley, MD

• Physician Assistant in Shreveport, LA
• Providers in Shreveport, LA by specialty
• Physician Assistant in Louisiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 13, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• 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.