Organization Active NPI

Jeffrey R O'Connor, M.D., PLLC

  • Family Medicine Physician
  • Spokane, WA
National Provider Identifier
1487755302
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
JEFFREY R O'CONNOR, M.D., PLLC
Practice address
9631 N Nevada St
310
Spokane, WA 99218-3406
Phone
(509) 467-6550
Fax
(509) 467-7665
NPI assigned
Sep 25, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Jeffrey Robert O'Connor
Title
Owner
Phone
(509) 467-6550

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207Q00000X Primary

Addresses

Primary practice location

9631 N Nevada St
310
Spokane, WA 99218-3406

Mailing address

9631 N Nevada St
310
Spokane, WA 99218-3406
Phone (509) 467-6550

Other identifiers 1

IdentifierTypeStateIssuer
7100274MedicaidWA

National Provider Directory

National Provider Directory

Locations

9631 N Nevada St
#310
Spokane, WA 99218
Phone (509) 467-6550

NPI Registry JSON

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

{
    "created_epoch": "1159142400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1487755302",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9631 N NEVADA ST",
            "address_2": "310",
            "city": "SPOKANE",
            "state": "WA",
            "postal_code": "992183406",
            "telephone_number": "509-467-6550",
            "fax_number": "509-467-7665"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9631 N NEVADA ST",
            "address_2": "310",
            "city": "SPOKANE",
            "state": "WA",
            "postal_code": "992183406",
            "telephone_number": "509-467-6550",
            "fax_number": "509-467-7665"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JEFFREY R O'CONNOR, M.D., PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-25",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "O'CONNOR",
        "authorized_official_first_name": "JEFFREY",
        "authorized_official_middle_name": "ROBERT",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "509-467-6550"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7100274",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Spokane, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.