Mark S McConnell, MD

Primary specialty

Critical Care Medicine (Internal Medicine) PhysicianTaxonomy code 207RC0200X

License

M9326 Issued in ID

Practice address

500 W. Fort St.
Mail Code 111
Boise, ID 83702-6241

Phone

(208) 422-1325

Fax

(208) 422-1319

NPI assigned

Aug 26, 2005

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in ID

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 1

Medicare enrollment (NPD)

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.

• Idaho Pulmonary Associates, PA

  • Pulmonary Disease Physician
  • Boise, ID
  • NPI 1679797468
  NPD (past)
• St Lukes Regional Medical Center

  • General Acute Care Hospital
  • Boise, ID
  • NPI 1447299342
  NPD (past)
• Firstcare Medical Foundation

  • Family Medicine Physician
  • Albany, OR
  • NPI 1740216498
  NPD (past)

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

{
    "created_epoch": "1125014400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1647993600000",
    "number": "1477546208",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "500 W. FORT ST.",
            "address_2": "MAIL CODE 111",
            "city": "BOISE",
            "state": "ID",
            "postal_code": "837026241",
            "telephone_number": "208-422-1325",
            "fax_number": "208-422-1319"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "500 W. FORT ST.",
            "address_2": "MAIL CODE 111",
            "city": "BOISE",
            "state": "ID",
            "postal_code": "837026241",
            "telephone_number": "208-422-1325",
            "fax_number": "208-422-1319"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCCONNELL",
        "first_name": "MARK",
        "middle_name": "S",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-08-26",
        "last_updated": "2022-03-23",
        "certification_date": "2022-03-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2080P0203X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Critical Care Medicine",
            "state": "ID",
            "license": "M9326",
            "primary": false
        },
        {
            "code": "207RC0200X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Critical Care Medicine",
            "state": "ID",
            "license": "M9326",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• McConnehey Holdings, Inc
• Brock McConnehey, DO
• Diane McConnehey, DO
• Lesa McConnel, LCSW
• Charles Benton McConnell, MA
• Wendolyn McConnell, PHARMD
• Maril McCord, RPT
• Kristen Francine McCormack, MA
• Kristine McCormick, PSYD
• Alaina A McCoy, MS PA-C

• Critical Care Medicine (Internal Medicine) Physician in Boise, ID
• Providers in Boise, ID by specialty
• Critical Care Medicine (Internal Medicine) Physician in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 23, 2022; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.