Individual provider Active NPI

Andrew Timothy Conner, PT, DPT

  • Physical Therapist
  • Memphis, TN
National Provider Identifier
1558038026
Registry record updated Sep 9, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
13761 Issued in TN
Practice address
1244 Primacy Pkwy
Memphis, TN 38119-0201
Phone
(901) 767-8690
Fax
(901) 763-1942
NPI assigned
Aug 24, 2021
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 9, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 13761 TN Primary

Addresses

Primary practice location

1244 Primacy Pkwy
Memphis, TN 38119-0201

Mailing address

1244 Primacy Pkwy
Memphis, TN 38119-0201
Phone (901) 767-8690

Other practice location 1

85 Market Center Dr
Collierville, TN 38017-6913
Phone (901) 861-9970

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TN, MS2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20210927002182 TN Practitioner - Physical Therapist in Private Practice 9133526650 Reassigns benefits to 1 organization
I20240501000075 MS Practitioner - Physical Therapist in Private Practice 9133526650 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
MSK Group PCGroup PAC ID 4688574262, shared by 10 NPIs, 138 clinicians

Practice addresses (Care Compare)

1244 Primary Pkwy
Memphis, TN 38119
Phone (901) 641-3000

2670 McIngvale Rd
Suite J
Hernando, MS 38632-8696
Phone (901) 641-3000

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
MSK Group PC Physical Therapist Current Accepting new patients
MSK Group, PC Physical Therapist CurrentSince Sep 1, 2022 Accepting new patients
MSK Group, PC Physical Therapist CurrentSince Sep 1, 2022 Accepting new patients

Locations

2670 McIngvale Rd
Ste J
Hernando, MS 38632
Phone (662) 548-2710

7580 Clarington Cv
Southaven, MS 38671
Phone (901) 259-1600

1244 Primacy Pkwy
Memphis, TN 38119
Phone (901) 767-8662

6286 Briarcrest Ave
#200
Memphis, TN 38120
Phone (901) 259-1600

6286 Briarcrest Ave
Ste 100
Memphis, TN 38120
Phone (901) 259-1600

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1629763200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1662681600000",
    "number": "1558038026",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1244 PRIMACY PKWY",
            "city": "MEMPHIS",
            "state": "TN",
            "postal_code": "381190201",
            "telephone_number": "901-767-8690",
            "fax_number": "901-763-1942"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1244 PRIMACY PKWY",
            "city": "MEMPHIS",
            "state": "TN",
            "postal_code": "381190201",
            "telephone_number": "901-767-8690",
            "fax_number": "901-763-1942"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "85 Market Center Dr",
            "address_purpose": "LOCATION",
            "city": "Collierville",
            "state": "TN",
            "postal_code": "380176913",
            "country_code": "US",
            "telephone_number": "901-861-9970",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CONNER",
        "first_name": "ANDREW",
        "middle_name": "TIMOTHY",
        "credential": "PT, DPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-08-24",
        "last_updated": "2022-09-09",
        "certification_date": "2022-09-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "TN",
            "license": "13761",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Memphis, TN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 9, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • 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.