Active NPI
Michael C Connelly, M.D.
- Pain Medicine (Anesthesiology) Physician
- Lawrence, MA
National Provider Identifier
1710987615
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pain Medicine (Anesthesiology) Physician
- License
- 58770
- Practice address
- 354 Merrimack St Ste 1
Lawrence, MA 01843-1755 - Phone
- (978) 687-2321
- Fax
- (978) 722-7287
- NPI assigned
- Jul 21, 2005
- Last updated
- Mar 4, 2020
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Interventional Pain Medicine Physician | 208VP0014X | 58770 | MA | |
| Pain Medicine (Anesthesiology) Physician | 207LP2900X | 58770 | MA | Primary |
| Pain Medicine (Anesthesiology) Physician | 207LP2900X | 12648 | NH |
Addresses
Primary practice location
354 Merrimack St Ste 1
Lawrence, MA 01843-1755
Mailing address
354 Merrimack Street
BLDG. 1
Lawrence, MA 01843
Phone (978) 687-2321
Other practice location 1
10 George St Ste 300
Lowell, MA 01852-2293
Phone (978) 687-2321
Other practice location 2
70 Butler St
Salem, NH 03079-3925
Phone (978) 687-2321
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)
- Enrolled
- Credentials
- Doctor of Medicine
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1121904000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1583280000000",
"number": "1710987615",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "354 MERRIMACK STREET",
"address_2": "BLDG. 1",
"city": "LAWRENCE",
"state": "MA",
"postal_code": "01843",
"telephone_number": "978-687-2321",
"fax_number": "978-722-7287"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "354 MERRIMACK ST STE 1",
"city": "LAWRENCE",
"state": "MA",
"postal_code": "018431755",
"telephone_number": "978-687-2321",
"fax_number": "978-722-7287"
}
],
"practiceLocations": [
{
"address_1": "10 George St Ste 300",
"address_purpose": "LOCATION",
"city": "Lowell",
"state": "MA",
"postal_code": "018522293",
"country_code": "US",
"telephone_number": "978-687-2321",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "70 Butler St",
"address_purpose": "LOCATION",
"city": "Salem",
"state": "NH",
"postal_code": "030793925",
"country_code": "US",
"telephone_number": "978-687-2321",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "CONNELLY",
"first_name": "MICHAEL",
"middle_name": "C",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2005-07-21",
"last_updated": "2020-03-04",
"certification_date": "2020-03-04",
"status": "A"
},
"taxonomies": [
{
"code": "208VP0014X",
"taxonomy_group": "",
"desc": "Pain Medicine, Interventional Pain Medicine",
"state": "MA",
"license": "58770",
"primary": false
},
{
"code": "207LP2900X",
"taxonomy_group": "",
"desc": "Anesthesiology, Pain Medicine",
"state": "MA",
"license": "58770",
"primary": true
},
{
"code": "207LP2900X",
"taxonomy_group": "",
"desc": "Anesthesiology, Pain Medicine",
"state": "NH",
"license": "12648",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Lawrence, MA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 4, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.