Individual provider Active NPI

Brandy M Conner, DO

  • Diagnostic Radiology Physician
  • Grand Rapids, MI
National Provider Identifier
1619230513
Registry record updated Jun 13, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
License
5101027968 Issued in MI
Practice address
3264 N Evergreen Dr NE
Grand Rapids, MI 49525-9746
Phone
(616) 363-7272
Fax
(616) 361-5828
NPI assigned
Jun 17, 2012
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 13, 2024

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology Physician 2085R0202X R8336 TX
Diagnostic Radiology Physician 2085R0202X 5101027968 MI Primary
Diagnostic Radiology Physician 2085R0202X 9407959 KS
Diagnostic Radiology Physician 2085R0202X 2019033205 MO

Addresses

Primary practice location

3264 N Evergreen Dr NE
Grand Rapids, MI 49525-9746

Mailing address

3264 N Evergreen Dr NE
Grand Rapids, MI 49525-9746
Phone (616) 363-7272

Other practice location 1

Emory University Hospital
Department of Radiology, Suite EG45
Atlanta, GA 30322
Phone (404) 778-3792

Other practice location 2

7900 Lees Summit Rd
Kansas City, MO 64139-1236
Phone (816) 404-0690

Other practice location 3

2301 Holmes St
Kansas City, MO 64108-2640
Phone (816) 404-0690

Other practice location 4

5323 Harry Hines Blvd
Dallas, TX 75390-2640
Phone (214) 648-7760

Other names 1

  • Brandy M Luff Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KS, TX, MI3 enrollments
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 3

Enrollment IDStateProvider typePAC IDDetails
I20141014000643 KS Practitioner - Diagnostic RadiologyPractitioner - Family Practice 0648490730 Reassigns benefits to 1 organization
I20181212001583 TX Practitioner - Diagnostic Radiology 0648490730 Reassigns benefits to 2 organizations
I20240514000531 MI Practitioner - Diagnostic Radiology 0648490730 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Diagnostic Radiology
Education
Other, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Advanced Radiology Services PCGroup PAC ID 4284546516, 252 clinicians

Practice addresses (Care Compare)

100 Michigan Ave NE
Grand Rapids, MI 49503-2560
Phone (616) 363-7272

7915 Sagamore Rd
Leawood, KS 66206-1228
Phone (616) 363-7272

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
82.87 of 100Reported as group
Quality
70.15
Promoting interoperability
100
Improvement activities
40
Cost
72.75

Merit-based Incentive Payment System (MIPS)

Final score
90.33 of 100Reported as group
Quality
91.31
Improvement activities
40
Cost
79.05

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

State licenses

LicenseStateTypeSpecialty
9407959KSMDDiagnostic Radiology Physician
2019033205MOMDDiagnostic Radiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Advanced Radiology Services PC Diagnostic Radiology CurrentSince Jun 1, 2024 Accepting new patients
The University of Texas Southwestern Medical Center at Dallas CurrentSince Nov 7, 2022 Accepting new patients
University of Texas Southwestern Medical Center at Dallas Current Accepting new patients
University of Texas Southwestern Medical Center at Dallas Diagnostic Radiology CurrentSince Nov 7, 2022 Accepting new patients
Texas Radiology Associates LLP Diagnostic Radiology CurrentSince Nov 1, 2018 Accepting new patients

Locations

3264 N Evergreen Dr NE
Grand Rapids, MI 49525
Phone (616) 391-6001

100 Michigan St NE
Grand Rapids, MI 49503
Phone (616) 391-1680

10057 County Road 472
Anna, TX 75409

1600 Hospital Pkwy
#L
Bedford, TX 76022
Phone (817) 848-4000

1600 Hospital Pkwy
Bedford, TX 76022
Phone (817) 355-7803

2350 N Stemmons Fwy
Dallas, TX 75207
Phone (469) 488-7100

5701 Maple Ave
Dallas, TX 75235
Phone (214) 246-3306

3000 N Interstate 35
Denton, TX 76201
Phone (469) 303-3591

3535 S Interstate 35 E
Denton, TX 76210
Phone (940) 384-3013

10864 Texas Health Trl
#L
Fort Worth, TX 76244
Phone (214) 647-5300

400 W Magnolia Ave
Ft Worth, TX 76104
Phone (817) 288-9700

600 S Main St
Ft Worth, TX 76104
Phone (817) 882-2400

1820 Preston Park Blvd
Ste 2400
Plano, TX 75093

401 W Campbell Rd
Richardson, TX 75080
Phone (940) 384-3535

5323 Harry Hines Blvd
Ut Southwest Medical Center, TX 75390

Organizations & group practices 5

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.

Hospital & facility affiliations 6

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1339891200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1718236800000",
    "number": "1619230513",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3264 N EVERGREEN DR NE",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495259746",
            "telephone_number": "616-363-7272",
            "fax_number": "616-361-5828"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3264 N EVERGREEN DR NE",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495259746",
            "telephone_number": "616-363-7272",
            "fax_number": "616-361-5828"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "Emory University Hospital",
            "address_2": "Department of Radiology, Suite EG45",
            "address_purpose": "LOCATION",
            "city": "Atlanta",
            "state": "GA",
            "postal_code": "30322",
            "country_code": "US",
            "telephone_number": "404-778-3792",
            "fax_number": "404-778-0221",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "7900 Lees Summit Rd",
            "address_purpose": "LOCATION",
            "city": "Kansas City",
            "state": "MO",
            "postal_code": "641391236",
            "country_code": "US",
            "telephone_number": "816-404-0690",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2301 Holmes St",
            "address_purpose": "LOCATION",
            "city": "Kansas City",
            "state": "MO",
            "postal_code": "641082640",
            "country_code": "US",
            "telephone_number": "816-404-0690",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "5323 Harry Hines Blvd",
            "address_purpose": "LOCATION",
            "city": "Dallas",
            "state": "TX",
            "postal_code": "753902640",
            "country_code": "US",
            "telephone_number": "214-648-7760",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CONNER",
        "first_name": "BRANDY",
        "middle_name": "M",
        "name_prefix": "Dr.",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-06-17",
        "last_updated": "2024-06-13",
        "certification_date": "2024-06-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "TX",
            "license": "R8336",
            "primary": false
        },
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "MI",
            "license": "5101027968",
            "primary": true
        },
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "KS",
            "license": "9407959",
            "primary": false
        },
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "MO",
            "license": "2019033205",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "BRANDY",
            "last_name": "LUFF",
            "middle_name": "M",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Grand Rapids, MI

Sources for this page

Verify at the official NPI Registry.