Kevin F Connolly, MD

Primary specialty

Neurology PhysicianTaxonomy code 2084N0400X

License

MD00014105 Issued in WA

Practice address

404-B Black Hills LN SW
Olympia, WA 98502-8148

Phone

(360) 438-2727

Fax

(360) 923-1120

NPI assigned

Jul 23, 2006

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 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

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.

• Capital Medical Center Specialty Physicians, LLC

  • Occupational Medicine Physician
  • Olympia, WA
  • NPI 1760785281
  NPD (past)

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

{
    "created_epoch": "1153612800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1237852800000",
    "number": "1457373391",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "404-B BLACK HILLS LN SW",
            "city": "OLYMPIA",
            "state": "WA",
            "postal_code": "985028148",
            "telephone_number": "360-438-2727",
            "fax_number": "360-923-1120"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "404-B BLACK HILLS LN SW",
            "city": "OLYMPIA",
            "state": "WA",
            "postal_code": "985028148",
            "telephone_number": "360-438-2727",
            "fax_number": "360-923-1120"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CONNOLLY",
        "first_name": "KEVIN",
        "middle_name": "F",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-23",
        "last_updated": "2009-03-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084N0400X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "WA",
            "license": "MD00014105",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LABOR & INDUSTRY",
            "identifier": "18095",
            "state": "WA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1849207",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Lisa D Condrad, M.D.
• William Lewis Conklin, MD
• Katharine Conley
• Thembi A Conner-Garcia, MD
• Bonnie Joe Connolly
• Kristen Connolly, PT
• Cassandra Fay Conrad
• Daniel Conrad, MD
• Erica Conrad
• Simon Conrad, LMHCA

• Neurology Physician in Olympia, WA
• Providers in Olympia, WA by specialty
• Neurology Physician in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 24, 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.