Douglas Allen Conner, MD

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

28181 Issued in KY

Practice address

413 S Loop Rd
St Elizabeth Family Practice Center
Edgewood, KY 41017-5446

Phone

(859) 301-3800

Fax

(859) 301-3987

NPI assigned

Mar 23, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 3

Medicare fee-for-service enrollment

Enrolled in KY

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

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.

• St Elizabeth Medical Center, Inc

  • Physician Assistant
  • Erlanger, KY
  • NPI 1932187937

  Family Medicine

  Medicare reassignment NPD
• University of Cincinnati Physicians Company, LLC

  • Family Medicine Physician
  • Cincinnati, OH
  • NPI 1801840434
  NPD (past)

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

{
    "created_epoch": "1143072000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1488931200000",
    "number": "1720048093",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "413 S LOOP RD",
            "address_2": "ST ELIZABETH FAMILY PRACTICE CENTER",
            "city": "EDGEWOOD",
            "state": "KY",
            "postal_code": "410175446",
            "telephone_number": "859-301-3800",
            "fax_number": "859-301-3987"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "413 S LOOP RD",
            "address_2": "ST ELIZABETH FAMILY PRACTICE CENTER",
            "city": "EDGEWOOD",
            "state": "KY",
            "postal_code": "410175446",
            "telephone_number": "859-301-3800",
            "fax_number": "859-301-3987"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CONNER",
        "first_name": "DOUGLAS",
        "middle_name": "ALLEN",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-03-23",
        "last_updated": "2017-03-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "KY",
            "license": "28181",
            "primary": true
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "IN",
            "license": "01067451A",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2213661",
            "state": "OH"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7100439330",
            "state": "KY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200407600",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Ricki L Collins, OT
• Brandie Nicole Combs, OTR/L
• Compass Emergency Physicians PSC
• Comprehensive Cardiology Consultants, Inc
• Kevin D. Connelly, MD
• Matthew James Connolly, D.P.M.
• Dorian Rae Cook
• Sean Patrick Cooney, CRNA
• Jessica Rose Cooper, MSN, APRN, FNP-BC
• Kaitlin Amanda Cooper, RBT

• Family Medicine Physician in Edgewood, KY
• Providers in Edgewood, KY by specialty
• Family Medicine Physician in Kentucky

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 8, 2017; 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.