Individual provider Active NPI

Edward J McConnell III, MD

  • Internal Medicine Physician
  • Newark, DE
National Provider Identifier
1942272315
Registry record updated Mar 6, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
C1-0001782 Issued in DE
Practice address
111 Continental Dr
Suite 406
Newark, DE 19713-4306
Phone
(302) 984-2577
Fax
(302) 368-1271
NPI assigned
Feb 1, 2006
Last updated
Mar 6, 2014By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 6, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X C1-0001782 DE Primary

Addresses

Primary practice location

111 Continental Dr
Suite 406
Newark, DE 19713-4306

Mailing address

111 Continental Dr
Suite 406
Newark, DE 19713-4306
Phone (302) 984-2577

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in DE
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 1

Enrollment IDStateProvider typePAC IDDetails
I20050509000958 DE Practitioner - Internal Medicine 3072553023 Reassigns benefits to 2 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
C1-0001782DEMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Inpatient Consultants of Delaware, LLC Internal Medicine CurrentSince Feb 22, 2013 Accepting new patients
Alignmed Partners, PC CurrentSince Jan 1, 2018 Accepting new patients
Delaware Diagnostic Services, Inc. PastSince May 1, 2004 Accepting new patients
Stoney Batter Family Medicine Associates, P.a. PastSince Aug 24, 1990 Accepting new patients
Kshama Garg Internal Medicine Past Accepting new patients
Regional Medical Group LLC PastSince Mar 1, 2013 Accepting new patients

Locations

32 Buena Vista Dr
New Castle, DE 19720
Phone (302) 328-1582

111 Continental Dr
Ste 102
Newark, DE 19713
Phone (302) 545-1777

111 Continental Dr
Ste 406
Newark, DE 19713
Phone (302) 368-2630

4755 Ogletown Stanton Rd
Newark, DE 19718
Phone (302) 733-1700

715 E King St
Seaford, DE 19973
Phone (302) 536-5628

3034 S DuPont Blvd
Smyrna, DE 19977
Phone (302) 653-5082

700 Foulk Rd
Wilmington, DE 19803
Phone (302) 328-1582

Organizations & group practices 6

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.

NPI Registry JSON

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

{
    "created_epoch": "1138752000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1394064000000",
    "number": "1942272315",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "111 CONTINENTAL DR",
            "address_2": "SUITE 406",
            "city": "NEWARK",
            "state": "DE",
            "postal_code": "197134306",
            "telephone_number": "302-984-2577",
            "fax_number": "302-368-1271"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "111 CONTINENTAL DR",
            "address_2": "SUITE 406",
            "city": "NEWARK",
            "state": "DE",
            "postal_code": "197134306",
            "telephone_number": "302-984-2577",
            "fax_number": "302-368-1271"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCCONNELL",
        "first_name": "EDWARD",
        "middle_name": "J",
        "name_prefix": "Dr.",
        "name_suffix": "III",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-02-01",
        "last_updated": "2014-03-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "DE",
            "license": "C1-0001782",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Newark, DE

Sources for this page

Verify at the official NPI Registry.