Conner Donald Sugrue, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

12462625-1206 Issued in UT

Practice address

707 E Mill Rd Ste 303
Vineyard, UT 84059-5730

Phone

(801) 224-1300

Fax

(801) 225-3236

NPI assigned

Jun 12, 2020

Last updated

Apr 29, 2022By the provider in NPPES

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 UT

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, 2021

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Ihc Health Services IncGroup PAC ID 1850209420, 3,948 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Ihc Health Services Inc

  • Multi-Specialty Clinic/Center
  • Sandy, UT
  • NPI 1942325154
  Medicare reassignment Care Compare group
• Premier Family Medical

  • Family Medicine Physician
  • Pleasant Grove, UT
  • NPI 1750725735
  Medicare reassignment
• Ihc Health Services Inc

  dba Lehi InstaCare

  • Urgent Care Clinic/Center
  • Lehi, UT
  • NPI 1164911962

  Family Medicine

  NPD
• Ihc Health Services, Inc.

  dba St George Adolescent Partial Hospitalization

  • Psychiatry Physician
  • St George, UT
  • NPI 1023843844
  NPD
• Premier Family Medical - City Center

  • Family Medicine Physician
  • Eagle Mountain, UT
  • NPI 1649160235
  NPD
• Premier Family Medical - Lindon Physical Therapy

  • Physical Therapist
  • Lindon, UT
  • NPI 1134563059
  NPD
• Ihc Health Services Inc

  dba Orem Community Hospital Physicians

  • Multi-Specialty Clinic/Center
  • Orem, UT
  • NPI 1588601124
  NPD (past)

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

{
    "created_epoch": "1591920000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1651190400000",
    "number": "1508481706",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "275 W 200 N",
            "city": "LINDON",
            "state": "UT",
            "postal_code": "840425009",
            "telephone_number": "801-769-2571",
            "fax_number": "801-443-1164"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "707 E MILL RD STE 303",
            "city": "VINEYARD",
            "state": "UT",
            "postal_code": "840595730",
            "telephone_number": "801-224-1300",
            "fax_number": "801-225-3236"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SUGRUE",
        "first_name": "CONNER",
        "middle_name": "DONALD",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-06-12",
        "last_updated": "2022-04-29",
        "certification_date": "2022-04-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "UT",
            "license": "12462625-1206",
            "primary": true
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Tom Sitake
• Jennifer Lin Sorge, DDS
• Southwest Spine and Pain Care Specialists, LLC
• Leah Stratton
• Ryan Thomas Sudweeks
• Heather Taylor, PTA
• Emily Rebecca Tew, RD
• Susana Vega, APRN
• Vineyard Counseling, LLC
• Vineyard Eye Care LLC

• Physician Assistant in Vineyard, UT
• Providers in Vineyard, UT by specialty
• Physician Assistant in Utah

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 29, 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.
• 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.