Individual provider Active NPI

John Brandon Connally

  • Peer Specialist
  • Lancaster, CA
National Provider Identifier
1528939634
Registry record updated Oct 24, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Peer SpecialistTaxonomy code 175T00000X
License
MPSS-CWOGHU Issued in CA
Practice address
44447 10TH St W
Lancaster, CA 93534-3324
Phone
(661) 726-2630
NPI assigned
Sep 13, 2025
Last updated
Oct 24, 2025By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 24, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Peer Specialist 175T00000X MPSS-CWOGHU CA Primary

Addresses

Primary practice location

44447 10TH St W
Lancaster, CA 93534-3324

Mailing address

37336 Calle Mazatlan
Palmdale, CA 93552-4728
Phone (661) 726-2630

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)
Not enrolled

State licenses

LicenseStateTypeSpecialty
MPSS-CWOGHUCAMDPeer Specialist

NPI Registry JSON

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

{
    "created_epoch": "1757721600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1761264000000",
    "number": "1528939634",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "37336 CALLE MAZATLAN",
            "city": "PALMDALE",
            "state": "CA",
            "postal_code": "935524728",
            "telephone_number": "661-726-2630"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "44447 10TH ST W",
            "city": "LANCASTER",
            "state": "CA",
            "postal_code": "935343324",
            "telephone_number": "661-726-2630"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CONNALLY",
        "first_name": "JOHN",
        "middle_name": "BRANDON",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2025-09-13",
        "last_updated": "2025-10-24",
        "certification_date": "2025-09-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "175T00000X",
            "taxonomy_group": "",
            "desc": "Peer Specialist",
            "state": "CA",
            "license": "MPSS-CWOGHU",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lancaster, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 24, 2025; 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.