Carolyn A Oconnor

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

MD00035321 Issued in WA

Practice address

336 Chardonnay Ave Ste a
Prosser, WA 99350-9515

Phone

(509) 786-1576

Fax

(509) 786-1574

NPI assigned

Jul 26, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in WA

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 Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: coconnor1110204@wm.providencedirect.org

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.

• Lourdes Hospital LLC

  • Internal Medicine Physician
  • Pasco, WA
  • NPI 1659861060

  Family Medicine

  Medicare reassignment NPD
• Prosser Public Hospital District of Benton County

  • Critical Access Hospital
  • Prosser, WA
  • NPI 1306897681
  Medicare reassignment NPD
• Lourdes Hospital LLC

  • Rehabilitation Hospital Unit
  • Pasco, WA
  • NPI 1497817654
  NPD
• Prosser Public Hospital District of Benton County

  • Rural Health Clinic/Center
  • Benton City, WA
  • NPI 1437199072
  NPD
• Prosser Public Hospital District of Benton County

  • Specialist
  • Walla Walla, WA
  • NPI 1518770155
  NPD
• Wwu Campus Health & Wellness

  • Student Health Clinic/Center
  • College Place, WA
  • NPI 1629048848
  NPD (past)

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

{
    "created_epoch": "1153872000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1622592000000",
    "number": "1962425322",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "723 MEMORIAL ST",
            "city": "PROSSER",
            "state": "WA",
            "postal_code": "993501524",
            "telephone_number": "509-786-2222",
            "fax_number": "509-786-6612"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "336 CHARDONNAY AVE STE A",
            "city": "PROSSER",
            "state": "WA",
            "postal_code": "993509515",
            "telephone_number": "509-786-1576",
            "fax_number": "509-786-1574"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OCONNOR",
        "first_name": "CAROLYN",
        "middle_name": "A",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-26",
        "last_updated": "2021-06-02",
        "certification_date": "2021-06-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "WA",
            "license": "MD00035321",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8214892",
            "state": "WA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "coconnor1110204@wm.providencedirect.org",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "336 Chardonnay Ave Ste A",
            "city": "Prosser",
            "state": "WA",
            "country_code": "US",
            "postal_code": "993509515",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Amanda Lorraine Nesary, L.M.P.
• Coy M Neville, PTA
• Katheryn Norris
• Jamie O'Banion
• John Oberman, PTA
• Abigale Grace Olive
• Riley Marie Olsen, PT, DPT
• Ashley Marie Olson
• Andrea Padilla, OTR/L
• Bailey Faye Padilla, CNM

• Family Medicine Physician in Prosser, WA
• Providers in Prosser, WA by specialty
• Family Medicine Physician in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 2, 2021; 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.