Connor Hays Gallentine, O.D.

Primary specialty

OptometristTaxonomy code 152W00000X

License

2079 Issued in KS

Practice address

22414 W 66TH St
Shawnee, KS 66226-3501

Phone

(913) 441-3937

Fax

(913) 441-3938

NPI assigned

Jun 26, 2018

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in KS

Eligible to order & refer

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

Green means eligible to order or refer.

Enrollment records 1

Specialty

Optometry

Education

Other, 2018

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Vision Care Associates, LLCGroup PAC ID 0345304267, 4 clinicians

Practice addresses (Care Compare)

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

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.

• Vision Care Associates, LLC

  • Optometrist
  • Shawnee, KS
  • NPI 1255582177
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1529971200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1529971200000",
    "number": "1770078305",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "22414 W 66TH ST",
            "city": "SHAWNEE",
            "state": "KS",
            "postal_code": "662263501",
            "telephone_number": "913-441-3937",
            "fax_number": "913-441-3938"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "22414 W 66TH ST",
            "city": "SHAWNEE",
            "state": "KS",
            "postal_code": "662263501",
            "telephone_number": "913-441-3937",
            "fax_number": "913-441-3938"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GALLENTINE",
        "first_name": "CONNOR",
        "middle_name": "HAYS",
        "name_prefix": "Mr.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-06-26",
        "last_updated": "2018-06-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "KS",
            "license": "2079",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Andrew Funk
• Brooklyn Funk
• Faythe Angeligue Gabriel, APRN
• Naomi Kiloko Gachanja, OPERATOR
• Olivia H. Gallagher
• Sharon Marie Gallivan, OT/L
• Kinsey Johnson Gann, PMHNP-BC
• Jatniel Garcia Lumbreras
• Kimberly Garcia-Flores
• Tracy Gardiner

• Optometrist in Shawnee, KS
• Providers in Shawnee, KS by specialty
• Optometrist in Kansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 26, 2018; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.