Kristy Michelle Conlon, DO

Primary specialty

Vascular Surgery PhysicianTaxonomy code 2086S0129X

License

78850 Issued in GA

Practice address

11909 McAuley Drive
BLDG 100 A2
Savannah, GA 31419

Phone

(912) 354-8331

Fax

(912) 352-9782

NPI assigned

Jun 5, 2010

Sex

Female

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Other identifiers 1

Other names 1

• Kristy Michelle Wiebke Former name

Medicare fee-for-service enrollment

Enrolled in GA

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

Specialty

Vascular Surgery

Education

Lake Erie College of Osteopathic Medicine, Erie, 2010

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

St. Joseph'S Vascular Group, LLCGroup PAC ID 6305163650, 6 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• St Joseph'S Hospital - Savannah Hospital, Savannah, GA, CCN 110043
• Candler Hospital Hospital, Savannah, GA, CCN 110024

Merit-based Incentive Payment System (MIPS)

Final score

75 of 100Reported as group

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: drwiebke@direct.sjchs.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.

• St. Joseph'S Vascular Group, LLC

  • Vascular Surgery Physician
  • Savannah, GA
  • NPI 1164829883
  Medicare reassignment Care Compare group NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Candler Hospital Incorporated

  • General Acute Care Hospital
  • Savannah, GA
  • NPI 1275527889
  Care Compare affiliation
• Saint Joseph'S Hospital, Inc.

  • General Acute Care Hospital
  • Savannah, GA
  • NPI 1063406684
  Care Compare affiliation

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

{
    "created_epoch": "1275696000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1615766400000",
    "number": "1982924502",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "836 E. 65TH STREET",
            "address_2": "SUITE 22",
            "city": "SAVANNAH",
            "state": "GA",
            "postal_code": "31405",
            "telephone_number": "912-819-7878",
            "fax_number": "912-819-3320"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11909 MCAULEY DRIVE",
            "address_2": "BLDG 100 A2",
            "city": "SAVANNAH",
            "state": "GA",
            "postal_code": "31419",
            "telephone_number": "912-354-8331",
            "fax_number": "912-352-9782"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CONLON",
        "first_name": "KRISTY",
        "middle_name": "MICHELLE",
        "name_prefix": "Dr.",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-06-05",
        "last_updated": "2021-03-15",
        "certification_date": "2021-03-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "FL",
            "license": "UO2440",
            "primary": false
        },
        {
            "code": "2086S0129X",
            "taxonomy_group": "",
            "desc": "Surgery, Vascular Surgery",
            "state": "GA",
            "license": "78850",
            "primary": true
        },
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "LA",
            "license": "DO000449",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "003194369A",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KRISTY",
            "last_name": "WIEBKE",
            "middle_name": "MICHELLE",
            "credential": "DO",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Peggy Sue Cone, LPN
• Derik Coney
• Jason P Conley, PHARMD
• Kaylen Grace Conley, APC
• Susanne S Conley, PHARMD
• Connect Care Medical LLC
• Caitlin Claire Conneff, CAA
• Meghan A Connelly, CRNA
• Timothy Patrick Connelly Jr., MD
• Julia Mac Conner Collins, LPC MAC

• Vascular Surgery Physician in Savannah, GA
• Providers in Savannah, GA by specialty
• Vascular Surgery Physician in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 15, 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.