Patrick Wellington Connelly, MD

Primary specialty

Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X

License

34632 Issued in AZ

Practice address

5300 S Sutter Dr
Suite 11
Show Low, AZ 85901-8050

Phone

(928) 537-9844

Fax

(928) 537-4437

NPI assigned

Oct 13, 2005

Last updated

Aug 25, 2016By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Mr. Patrick Wellington Connelly Professional name

Medicare fee-for-service enrollment

Enrolled in AZ

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: patrick.connelly@azf017.digichart.direct-ci.com

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.

• Kingman Healthcare, Inc

  dba Kingman Regional Medical Center

  • General Acute Care Hospital
  • Kingman, AZ
  • NPI 1265423917

  Family Medicine

  Medicare reassignment NPD
• Summit Healthcare Medical Associates

  • Family Medicine Physician
  • Show Low, AZ
  • NPI 1467878108
  Medicare reassignment NPD
• Connelly Care PLLC

  • Specialist
  • Show Low, AZ
  • NPI 1255429353
  Authorized official Same address or phone
• Kingman Healthcare, Inc

  • Specialist
  • Kingman, AZ
  • NPI 1689897787

  Family Medicine

  NPD
• Kingman Healthcare, Inc

  dba KRMC Community Pharmacy

  • Community/Retail Pharmacy
  • Kingman, AZ
  • NPI 1992286298
  NPD
• Summit Healthcare Medical Associates

  • Rural Health Clinic/Center
  • Eagar, AZ
  • NPI 1063166999
  NPD
• Summit Healthcare Association

  dba Summit Healthcare Regional Medical Center

  • Rural Acute Care Hospital
  • Show Low, AZ
  • NPI 1144209271
  NPD (past)

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

{
    "created_epoch": "1129161600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1472083200000",
    "number": "1619965548",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5300 S SUTTER DR",
            "address_2": "SUITE 11",
            "city": "SHOW LOW",
            "state": "AZ",
            "postal_code": "859018050",
            "telephone_number": "928-537-9844",
            "fax_number": "928-537-4437"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5300 S SUTTER DR",
            "address_2": "SUITE 11",
            "city": "SHOW LOW",
            "state": "AZ",
            "postal_code": "859018050",
            "telephone_number": "928-537-9844",
            "fax_number": "928-537-4437"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CONNELLY",
        "first_name": "PATRICK",
        "middle_name": "WELLINGTON",
        "name_prefix": "Mr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-10-13",
        "last_updated": "2016-08-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "AZ",
            "license": "34632",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GROUP NPI",
            "identifier": "1255429353",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "PATRICK",
            "last_name": "CONNELLY",
            "middle_name": "WELLINGTON",
            "prefix": "MR.",
            "credential": "MD",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

• Community Medical Services Arizona-Private, LLC (Community Medical Services-Show Low)
• Community Medical Services Arizona-Private, LLC (Community Medical Services Show Low)
• Comprehensive Hospitalist Services of Arizona LLC
• Comprehensive Hospitalist Services of Arizona, LLC
• Connelly Care PLLC
• Courtney Ann Contreras, PA
• Deanna Cook, RPH
• Elmer Alfred Cook Jr., RPH, MBA
• Dessa M Cooper, CPM, LM
• Randal Lloyd Cooper, MD

• Obstetrics & Gynecology Physician in Show Low, AZ
• Providers in Show Low, AZ by specialty
• Obstetrics & Gynecology Physician in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 25, 2016; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.