Katherine Marie Connelly, MD

Primary specialty

Emergency Medicine PhysicianTaxonomy code 207P00000X

License

81557-20 Issued in WI

Practice address

3703 Grovedale PL Apt 2
Cincinnati, OH 45208-1108

Phone

(720) 840-0147

NPI assigned

Mar 29, 2018

Last updated

Aug 20, 2024By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Enrolled in OH, WI2 enrollments

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 2

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• University of Cincinnati Physicians Company, LLC

  • Family Medicine Physician
  • Cincinnati, OH
  • NPI 1801840434
  Medicare reassignment NPD
• Southern Wisconsin Emergency Associates SC

  • Emergency Medicine Physician
  • Beloit, WI
  • NPI 1568538189
  Medicare reassignment NPD

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

{
    "created_epoch": "1522281600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1724112000000",
    "number": "1912402140",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3703 GROVEDALE PL APT 2",
            "city": "CINCINNATI",
            "state": "OH",
            "postal_code": "452081108"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3703 GROVEDALE PL APT 2",
            "city": "CINCINNATI",
            "state": "OH",
            "postal_code": "452081108",
            "telephone_number": "720-840-0147"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "234 Goodman Street",
            "address_2": "Center for Emergency Care",
            "address_purpose": "LOCATION",
            "city": "Cincinnati",
            "state": "OH",
            "postal_code": "452190796",
            "country_code": "US",
            "telephone_number": "513-558-5281",
            "fax_number": "513-558-5791",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "4777 E Galbraith Rd",
            "address_purpose": "LOCATION",
            "city": "Cincinnati",
            "state": "OH",
            "postal_code": "452362725",
            "country_code": "US",
            "telephone_number": "513-558-5281",
            "fax_number": "513-558-5791",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CONNELLY",
        "first_name": "KATHERINE",
        "middle_name": "MARIE",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-03-29",
        "last_updated": "2024-08-20",
        "certification_date": "2024-08-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "OH",
            "license": "35.142306",
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "WI",
            "license": "81557-20",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• John Connell, P.T.
• Kristen Connell
• Samantha Marie Connellan, LSW
• Beverly L Connelly, M.D.
• Kaitlin Grace Connelly
• Arielle L Conner
• Chasity M Conner
• Drew H Conner
• Erin Elizabeth Conner, CNP
• Misti Conner

• Emergency Medicine Physician in Cincinnati, OH
• Providers in Cincinnati, OH by specialty
• Emergency Medicine Physician in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 20, 2024; 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.