Individual provider Active NPI

John E Oconnor, M.D.

  • Family Medicine Physician
  • Lakewood, CO
National Provider Identifier
1417928003
Registry record updated Dec 10, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
34077 Issued in CO
Practice address
205 S Garrison St
Lakewood, CO 80226-2843
Phone
(303) 237-2779
Fax
(303) 237-4428
NPI assigned
Jan 31, 2006
Last updated
Dec 10, 2009By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 10, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 34077 CO Primary

Addresses

Primary practice location

205 S Garrison St
Lakewood, CO 80226-2843

Mailing address

205 S Garrison St
Lakewood, CO 80226-2843
Phone (303) 237-2779

Other identifiers 3

IdentifierTypeStateIssuer
01340777MedicaidCO
80226A005OtherTRICARE
080165174OtherRR MEDICARE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
34077COMDFamily Medicine Physician

NPI Registry JSON

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

{
    "created_epoch": "1138665600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1260403200000",
    "number": "1417928003",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "205 S GARRISON ST",
            "city": "LAKEWOOD",
            "state": "CO",
            "postal_code": "802262843",
            "telephone_number": "303-237-2779",
            "fax_number": "303-237-4428"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "205 S GARRISON ST",
            "city": "LAKEWOOD",
            "state": "CO",
            "postal_code": "802262843",
            "telephone_number": "303-237-2779",
            "fax_number": "303-237-4428"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OCONNOR",
        "first_name": "JOHN",
        "middle_name": "E",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-01-31",
        "last_updated": "2009-12-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CO",
            "license": "34077",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01340777",
            "state": "CO"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TRICARE",
            "identifier": "80226A005",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE",
            "identifier": "080165174",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Lakewood, CO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 10, 2009; 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.