Active NPI
Connie M O'Connor
- Psychiatry Physician
- Seattle, WA
National Provider Identifier
1811004286
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychiatry Physician
- License
- MD00044929
- Practice address
- 1959 NE Pacific St
C212, Box 356340
Seattle, WA 98195-6340 - Phone
- (206) 543-0065
- NPI assigned
- Aug 23, 2006
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychiatry Physician | 2084P0800X | MD00044929 | WA | Primary |
Addresses
Primary practice location
1959 NE Pacific St
C212, Box 356340
Seattle, WA 98195-6340
Mailing address
1959 NE Pacific St
C212, Box 356340
Seattle, WA 98195-6340
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0000917190 | Other | MT | BLUE CROSS-SHIELD OF MONTANA CENTER FOR MENTAL HEALTH |
| P01205491 C01340 | Other | MT | RAILROAD MEDICARE FOR C4MH |
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| MD00044929 | WA | MD | Psychiatry Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Center for Mental Health | Past | Accepting new patients |
Organizations & group practices 1
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.
-
- Mental Illness Community Based Residential Treatment Facility
- Great Falls, MT
- NPI 1710450044
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1156291200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1380499200000",
"number": "1811004286",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1959 NE PACIFIC ST",
"address_2": "C212, BOX 356340",
"city": "SEATTLE",
"state": "WA",
"postal_code": "981956340"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1959 NE PACIFIC ST",
"address_2": "C212, BOX 356340",
"city": "SEATTLE",
"state": "WA",
"postal_code": "981956340",
"telephone_number": "206-543-0065"
}
],
"practiceLocations": [],
"basic": {
"last_name": "O'CONNOR",
"first_name": "CONNIE",
"middle_name": "M",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-08-23",
"last_updated": "2013-09-30",
"status": "A"
},
"taxonomies": [
{
"code": "2084P0800X",
"taxonomy_group": "",
"desc": "Psychiatry & Neurology, Psychiatry",
"state": "WA",
"license": "MD00044929",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE CROSS-SHIELD OF MONTANA CENTER FOR MENTAL HEALTH",
"identifier": "0000917190",
"state": "MT"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "RAILROAD MEDICARE FOR C4MH",
"identifier": "P01205491 C01340",
"state": "MT"
}
],
"endpoints": [],
"other_names": []
}Other providers in Seattle, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 30, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.