Conner Thomas Livingston, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

085.010583 Issued in IL

Practice address

3311 N Halsted St
Chicago, IL 60657-2412

Phone

(773) 435-9994

NPI assigned

Aug 19, 2024

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in IL

Eligible to order & refer

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

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: conner.livingston.1@26356.direct.athenahealth.com

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.

• AIDS Healthcare Foundation

  • Infectious Disease Physician
  • Chicago, IL
  • NPI 1437775038
  Medicare reassignment NPD
• AIDS Healthcare Foundation

  • Community/Retail Pharmacy
  • Baton Rouge, LA
  • NPI 1891525184
  NPD

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

{
    "created_epoch": "1724025600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1728604800000",
    "number": "1912739780",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4755 N MALDEN ST APT GS",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606404386"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3311 N HALSTED ST",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606572412",
            "telephone_number": "773-435-9994"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LIVINGSTON",
        "first_name": "CONNER",
        "middle_name": "THOMAS",
        "name_prefix": "Mr.",
        "credential": "PA-C",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2024-08-19",
        "last_updated": "2024-10-11",
        "certification_date": "2024-10-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "IL",
            "license": "085.010583",
            "primary": true
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Living Well Health Management Inc
• Living With Purpose Inc
• Barbara Livingston-Goschi, PSY D
• Andraya Livingston
• Catina Livingston
• David Livingston
• Khadijah A Livingston
• Stephanie L Livingston, PH.D.
• Tirrell Antoine Livingston
• Torie Alexandria Livingston, MD

• Physician Assistant in Chicago, IL
• Providers in Chicago, IL by specialty
• Physician Assistant in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 11, 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.