NPIMap

Organization Active NPI

Robert J McConnell

  • Geriatric Medicine (Internal Medicine) Physician
  • Vandalia, OH
National Provider Identifier
1750570164
Registry record updated Nov 1, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Geriatric Medicine (Internal Medicine) PhysicianTaxonomy code 207RG0300X
License
1569 Issued in OH
Legal business name
ROBERT J MCCONNELL
Practice address
107 Kenbrook Dr
Vandalia, OH 45377-2427
Phone
(937) 890-6252
Fax
(937) 890-1725
NPI assigned
Oct 22, 2007
Last updated
Nov 1, 2010By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 1, 2010

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

Authorized official

Name
Dr. Robert J McConnell, D.O.NPI 1053393934
Title
Owner
Phone
(937) 890-6252

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Geriatric Medicine (Internal Medicine) PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207RG0300X 1569 OH Primary

Addresses

Primary practice location

107 Kenbrook Dr
Vandalia, OH 45377-2427

Mailing address

P.O. Box 235
Vandalia, OH 45377-2427
Phone (937) 890-6252

Other identifiers 2

IdentifierTypeStateIssuer
0877761MedicaidOH
DP5373OtherOHRAILROAD MEDICARE

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1193011200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1288569600000",
    "number": "1750570164",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "P.O. BOX 235",
            "city": "VANDALIA",
            "state": "OH",
            "postal_code": "453772427",
            "telephone_number": "937-890-6252",
            "fax_number": "937-890-1725"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "107 KENBROOK DR",
            "city": "VANDALIA",
            "state": "OH",
            "postal_code": "453772427",
            "telephone_number": "937-890-6252",
            "fax_number": "937-890-1725"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ROBERT J MCCONNELL",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-10-22",
        "last_updated": "2010-11-01",
        "status": "A",
        "authorized_official_last_name": "MCCONNELL",
        "authorized_official_first_name": "ROBERT",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "937-890-6252",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.O."
    },
    "taxonomies": [
        {
            "code": "207RG0300X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine, Geriatric Medicine",
            "state": "OH",
            "license": "1569",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0877761",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "DP5373",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Vandalia, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 1, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.