John J Connolly III, M.D.

Primary specialty

Geriatric Medicine (Internal Medicine) PhysicianTaxonomy code 207RG0300X

License

104160 Issued in MO

Practice address

19550 E 39TH St S
Suite 245
Independence, MO 64057-2303

Phone

(816) 373-0655

Fax

(816) 478-6374

NPI assigned

May 5, 2006

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

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.

• Gregory L Hummel MD PC

  • Orthopaedic Surgery Physician
  • Independence, MO
  • NPI 1942377320
  NPD (past)
• Independence Medical Group PC

  • Specialist
  • Independence, MO
  • NPI 1255545737
  NPD (past)
• Independence Regional Medical Group LLC

  • Family Medicine Physician
  • Independence, MO
  • NPI 1922054295
  NPD (past)
• Robert H and Teresita S Petty

  • Anesthesiology Physician
  • Effingham, IL
  • NPI 1306913868
  NPD (past)

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

{
    "created_epoch": "1146787200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1245024000000",
    "number": "1962450312",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "19550 E 39TH ST S",
            "address_2": "SUITE 245",
            "city": "INDEPENDENCE",
            "state": "MO",
            "postal_code": "640572303",
            "telephone_number": "816-373-0655",
            "fax_number": "816-478-6374"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "19550 E 39TH ST S",
            "address_2": "SUITE 245",
            "city": "INDEPENDENCE",
            "state": "MO",
            "postal_code": "640572303",
            "telephone_number": "816-373-0655",
            "fax_number": "816-478-6374"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CONNOLLY",
        "first_name": "JOHN",
        "middle_name": "J",
        "name_prefix": "Dr.",
        "name_suffix": "III",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-05",
        "last_updated": "2009-06-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RG0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Geriatric Medicine",
            "state": "MO",
            "license": "104160",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Community Birth Group
• Comprehensive Foot Centers P.a.
• Chris Allen Condra, M.S.
• Kate E Coniglio, ACNP-BC
• Myra Conner
• Consultants in Gastroenterology, PC
• Danielle Marie Cool, LCSW, LSCSW
• Aidan Coolidge, BCBA
• William T Cooper, CRNA
• Joy G. Copeland, M.ED., LPC

• Geriatric Medicine (Internal Medicine) Physician in Independence, MO
• Providers in Independence, MO by specialty
• Geriatric Medicine (Internal Medicine) Physician in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 15, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.