NPIMap

Individual provider Active NPI

Christopher J Connolly, M.D.

  • Family Medicine Physician
  • Omaha, NE
National Provider Identifier
1881616167
Registry record updated Dec 9, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
22016 Issued in NE
Practice address
13315 W Center Rd
Suite 100
Omaha, NE 68144-3449
Phone
(402) 717-9400
Fax
(402) 717-9401
NPI assigned
Jul 24, 2006
Last updated
Dec 9, 2015By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 9, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 22016 NE Primary

Addresses

Primary practice location

13315 W Center Rd
Suite 100
Omaha, NE 68144-3449

Mailing address

7261 Mercy Rd
Omaha, NE 68124-2311

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NE
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20090407000249 NE Practitioner - Family Practice 6204917875 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
University of Nebraska College of Medicine, 2000
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Alegent Creighton ClinicGroup PAC ID 1951210418, 951 clinicians

Practice addresses (Care Compare)

16901 Lakeside Hills CT
Omaha, NE 68130-2318
Phone (855) 524-4001

16909 Lakeside Hills CT
Omaha, NE 68130-4661

5045 S 153Rd St
Omaha, NE 68137-5001
Phone (402) 717-9100

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions1-10
Skin biopsy1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
22016NEMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Alegent Creighton Clinic Family Medicine CurrentSince Apr 1, 2009 Accepting new patients
Midwest Family Physicians. PC Family Medicine Past Accepting new patients
Alegent Creighton Clinic Family Medicine Past Accepting new patients

Locations

2771 Solution Ctr
Chicago, IL 60677

1130 N 204th Ave
Elkhorn, NE 68022
Phone (402) 289-3377

13315 W Center Rd
Ste 100
Omaha, NE 68144
Phone (402) 717-9400

16909 Lakeside Hills Ct
Ste 401
Omaha, NE 68130
Phone (402) 827-4920

7261 Mercy Rd
Omaha, NE 68124
Phone (402) 398-6248

Interoperability endpoints

  • Direct secure messaging: cconnolly8547@achce.catholichealth.net

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 7

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1153699200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1449619200000",
    "number": "1881616167",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7261 MERCY RD",
            "city": "OMAHA",
            "state": "NE",
            "postal_code": "681242311"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13315 W CENTER RD",
            "address_2": "SUITE 100",
            "city": "OMAHA",
            "state": "NE",
            "postal_code": "681443449",
            "telephone_number": "402-717-9400",
            "fax_number": "402-717-9401"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CONNOLLY",
        "first_name": "CHRISTOPHER",
        "middle_name": "J",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-24",
        "last_updated": "2015-12-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NE",
            "license": "22016",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Omaha, NE

Sources for this page

Verify at the official NPI Registry.