John Concannon, DO

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

DO-00357 Issued in RI

Practice address

1145 Reservoir Ave
Suite 124
Cranston, RI 02920-6055

Phone

(401) 943-7337

Fax

(401) 942-1509

NPI assigned

Jul 2, 2005

Reactivated

Mar 25, 2006

Last updated

Jul 8, 2007By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in RI

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: jconcannon@direct.carene.org

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.

• DRS. Concannon and Vitale, LLC

  dba Atlantic Pediatrics

  • Pediatrics Physician
  • Cranston, RI
  • NPI 1366402018
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1120262400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1962409128",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1145 RESERVOIR AVE",
            "address_2": "SUITE 124",
            "city": "CRANSTON",
            "state": "RI",
            "postal_code": "029206055",
            "telephone_number": "401-943-7337",
            "fax_number": "401-942-1509"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1145 RESERVOIR AVE",
            "address_2": "SUITE 124",
            "city": "CRANSTON",
            "state": "RI",
            "postal_code": "029206055",
            "telephone_number": "401-943-7337",
            "fax_number": "401-942-1509"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CONCANNON",
        "first_name": "JOHN",
        "name_prefix": "Dr.",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-07-02",
        "last_updated": "2007-07-08",
        "deactivation_date": "2006-03-20",
        "reactivation_date": "2006-03-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "RI",
            "license": "DO-00357",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Comprehensive Community Action, Inc
• Comprehensive Community Action, Inc
• Comprehensive Community Action, Inc. (Family Health Services)
• Comprehensive Home Medical Equipment Inc
• Comprehensive OB/GYN Care, Inc
• Concord Health Services, Inc (Concord Home Health Services)
• Concord Physical Therapy Inc.
• Alanna Conley
• Moriah Connor, BCBA
• Haley Connors, LCSW

• Pediatrics Physician in Cranston, RI
• Providers in Cranston, RI by specialty
• Pediatrics Physician in Rhode Island

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.