Kevin T Oconnor DO PC

Primary specialty

Surgery PhysicianTaxonomy code 208600000X

License

5101010639 Issued in MI

Legal business name

KEVIN T OCONNOR DO PC

Practice address

421 S Baldwin St
Greenville, MI 48838-2102

Phone

(989) 584-6801

NPI assigned

Oct 3, 2007

Organization subpart

No

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

Authorized official

Name

Dr. Kevin T Oconnor, DONPI 1659335396

Title

President

Phone

(989) 584-6801

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in MI

Enrollment records 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Kevin T Oconnor, DO

  • Surgery Physician
  • Greenville, MI
  • NPI 1659335396
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1191369600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1193184000000",
    "number": "1932396942",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 326",
            "city": "CARSON CITY",
            "state": "MI",
            "postal_code": "488110326",
            "telephone_number": "989-584-6801"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "421 S BALDWIN ST",
            "city": "GREENVILLE",
            "state": "MI",
            "postal_code": "488382102",
            "telephone_number": "989-584-6801"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KEVIN T OCONNOR DO PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-10-03",
        "last_updated": "2007-10-24",
        "status": "A",
        "authorized_official_last_name": "OCONNOR",
        "authorized_official_first_name": "KEVIN",
        "authorized_official_middle_name": "T",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "989-584-6801",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DO"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Surgery",
            "state": "MI",
            "license": "5101010639",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3526975",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "0255900344",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Andrew Kalman, PHARM.D.
• Cody A Katerberg, LLMSW
• David I Kay, MD
• Tiffany Kelley, PHARMD
• James Howard Kelly, RPH
• Kimberlee J Odonald PT PC
• Kimberly B Lavender, LLC
• Jenny E Kipp, DNP
• Tammy Kay Kirby, ARNP-C
• Rachel Kloosterman

• Surgery Physician in Greenville, MI
• Providers in Greenville, MI by specialty
• Surgery Physician in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 24, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.