Individual provider Active NPI

Evan Conner, M.D.

  • Emergency Medicine Physician
  • Saint Louis, MO
National Provider Identifier
1619328648
Registry record updated Sep 29, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
MD61068604 Issued in WA
Practice address
1 Barnes Jewish Hospital PLZ
Saint Louis, MO 63110-1003
Phone
(314) 362-5000
NPI assigned
Jun 30, 2016
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 29, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207P00000X MD61068604 WA Primary
Emergency Medicine Physician 207P00000X 2016017318 MO

Addresses

Primary practice location

1 Barnes Jewish Hospital PLZ
Saint Louis, MO 63110-1003

Mailing address

660 S Euclid Ave
Saint Louis, MO 63110-1010
Phone (314) 362-5000

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA
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 1

Enrollment IDStateProvider typePAC IDDetails
I20200826003666 WA Practitioner - Emergency Medicine 6709203441 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Emergency Medicine
Education
Tulane University School of Medicine, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

315 Martin Luther King Jr Way
Tacoma, WA 98405-4234
Phone (253) 403-1000

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
2016017318MOMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Multicare Health System Multi-Specialty Current Accepting new patients
Olympia Emergency Care Physicians PLLC Multi-Specialty CurrentSince Jun 1, 2022 Accepting new patients
Multicare Health System CurrentSince Sep 2, 2020 Accepting new patients
Multicare Health System Multi-Specialty CurrentSince Sep 2, 2020 Accepting new patients
Tacoma Emergency Care Physicians, PLLC Emergency Medicine CurrentSince Aug 28, 2020 Accepting new patients
Tacoma Emergency Care Physicians, PLLC Multi-Specialty Current Accepting new patients

Locations

17700 SE 272nd St
Kent, WA 98042
Phone (253) 372-6500

3900 Capital Mall Dr SW
Olympia, WA 98502
Phone (360) 704-4743

317 Martin Luther King Jr Way
Tacoma, WA 98405
Phone (253) 403-1400

315 S K St
Tacoma, WA 98405
Phone (253) 403-1291

Organizations & group practices 6

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 2

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": "1467244800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1601337600000",
    "number": "1619328648",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "660 S EUCLID AVE",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631101010",
            "telephone_number": "314-362-5000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 BARNES JEWISH HOSPITAL PLZ",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631101003",
            "telephone_number": "314-362-5000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CONNER",
        "first_name": "EVAN",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2016-06-30",
        "last_updated": "2020-09-29",
        "certification_date": "2020-09-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Emergency Medicine",
            "state": "WA",
            "license": "MD61068604",
            "primary": true
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "MO",
            "license": "2016017318",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Saint Louis, MO

Sources for this page

Verify at the official NPI Registry.