KEITH CONNOLLY (NPI# 1811333008) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1811333008 |
| Entity Type | Individual |
| Full Name | KEITH CONNOLLY |
| Credential | MD |
| Practice Address |
1414 W Fair Ave Ste 190 Marquette MI 49855-5406 |
| Practice Telephone | 9062251321 |
| Practice Fax Number | 9062289371 |
| Mailing Telephone | 9062251321 |
| Mailing Fax Number | 9062289371 |
| Enumeration Date | 2013-05-15 |
| Last Update Date | 2019-08-02 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207X00000X | Orthopaedic Surgery | 4301117275 | MI | Allopathic & Osteopathic Physicians |
| N | 207X00000X | Orthopaedic Surgery | MT203824 | PA | Allopathic & Osteopathic Physicians |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 3400 Spruce St, Philadelphia, PA 191044206 | 2153498731 |
| Street Address |
1414 W FAIR AVE STE 190 |
| City | MARQUETTE |
| State | MI |
| Zip Code | 49855-5406 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1972511533 | Victoria N Asmus | Physician Assistant | 1414 W Fair Ave Ste 190, Marquette, MI 49855-5406 | 2006-08-03 |
| 1467063966 | Justin S. Kleinschmidt | Nurse Practitioner | 1414 W Fair Ave Ste 190, Marquette, MI 49855-5406 | 2020-08-10 |
| 1558987313 | Chelsea E Greenleaf | Physician Assistant | 1414 W Fair Ave Ste 190, Marquette, MI 49855-5406 | 2020-06-17 |
| 1487006896 | Scot M Koski | Physician Assistant | 1414 W Fair Ave Ste 190, Marquette, MI 49855-5406 | 2016-07-09 |
| 1831567783 | Bradley F Benson | Podiatrist | 1414 W Fair Ave Ste 190, Marquette, MI 49855 | 2015-09-09 |
| 1205191285 | Andrew G Swentik | Orthopaedic Surgery | 1414 W Fair Ave Ste 190, Marquette, MI 49855-5406 | 2012-07-06 |
| 1609165448 | Garrett James Kerns | Orthopaedic Surgery | 1414 W Fair Ave Ste 190, Marquette, MI 49855-5406 | 2011-04-01 |
| 1447379532 | Jill A. Magel | Physician Assistant | 1414 W Fair Ave Ste 190, Marquette, MI 49855-5406 | 2007-03-28 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1023665064 | Scott Allen Poirier | Physician Assistant | 850 West Baraga Avenue, Marquette, MI 49855 | 2019-08-23 |
| 1730734831 | Katelyn Tourville | Physician Assistant | 1401 Presque Isle Ave-health Center, Marquette, MI 49855 | 2019-08-06 |
| 1932681095 | Katelyn Longanbach | Physical Therapist | 841 W Washington St Ste 500, Marquette, MI 49855 | 2018-09-05 |
| 1366943979 | Meijer, Inc. | Durable Medical Equipment & Medical Supplies | 3630 Us 41 W, Marquette, MI 49855 | 2018-02-28 |
| 1518466143 | Orthopaedic Surgery Associates of Marquette PC | Prosthetic/Orthotic Supplier | 841 West Washington Street, Suite 100, Marquette, MI 49855 | 2018-02-09 |
| 1376075598 | Pamela Baynton | Licensed Practical Nurse | 2292 U.S. 41 W, Marquette, MI 49855 | 2017-03-28 |
| 1548709454 | Allison Jean Czarny | Registered Nurse | 160 E Wright Pl, Marquette, MI 49855 | 2017-02-13 |
| 1629427299 | Larry Chappel | Social Worker | 210 Chippewa Square, Suite 208, Marquette, MI 49855 | 2016-06-06 |
| 1366898348 | Carla Pate | Student in an Organized Health Care Education/Training Program | 235 Hunt Hall, Marquette, MI 49855 | 2016-05-10 |
| 1922479732 | Nicholas Wujcik | Student in an Organized Health Care Education/Training Program | 504 S Fifth St, Marquette, MI 49855 | 2015-10-20 |
| Find all providers in zip 49855 | ||||
| Taxonomy Code | 207X00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Orthopaedic Surgery |
| An orthopaedic surgeon is trained in the preservation, investigation and restoration of the form and function of the extremities, spine and associated structures by medical, surgical and physical means. An orthopaedic surgeon is involved with the care of patients whose musculoskeletal problems include congenital deformities, trauma, infections, tumors, metabolic disturbances of the musculoskeletal system, deformities, injuries and degenerative diseases of the spine, hands, feet, knee, hip, shoulder and elbow in children and adults. An orthopaedic surgeon is also concerned with primary and secondary muscular problems and the effects of central or peripheral nervous system lesions of the musculoskeletal system. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definiton added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Orthopaedic Surgery, 2007. http://www.abos.org/. American Osteopathic Board of Orthopaedic Surgery, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Orthopaedic Surgery. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Orthopaedic Surgery. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1205191285 | Andrew G Swentik | Orthopaedic Surgery | 1414 W Fair Ave Ste 190, Marquette, MI 49855-5406 | 2012-07-06 |
| 1609165448 | Garrett James Kerns | Orthopaedic Surgery | 1414 W Fair Ave Ste 190, Marquette, MI 49855-5406 | 2011-04-01 |
| 1528203247 | Jason Doppelt | Orthopaedic Surgery | 1414 W Fair Ave, Suite 190, Marquette, MI 49855-2675 | 2008-12-09 |
| 1619124906 | Timothy Bruce Neuschwander | Orthopaedic Surgery | 1414 W Fair Ave, Advanced Center for Orthopedics, Suite 190, Marquette, MI 49855-2675 | 2008-08-19 |
| 1508022609 | Bradley Q Warlick | Orthopaedic Surgery | 1414 W Fair Ave, Suite 190, Marquette, MI 49855-2675 | 2008-07-29 |
| 1477769891 | Zachary Leonard | Orthopaedic Surgery | 1414 W Fair Ave, Suite 190, Marquette, MI 49855-2675 | 2007-05-15 |
| 1861403719 | Robert Howells Blotter | Orthopaedic Surgery | 1414 W Fair Ave, Suite 190, Marquette, MI 49855-2675 | 2006-08-10 |
| 1265443741 | Kenneth Allan Davenport | Orthopaedic Surgery | 1414 W Fair Ave, Suite 190, Marquette, MI 49855-2675 | 2006-08-10 |
| 1881605350 | Wallace George Pearson II | Orthopaedic Surgery | 1414 W Fair Ave, Suite 149, Marquette, MI 49855 | 2006-08-10 |
| 1285655753 | Clayton Austin Peimer | Orthopaedic Surgery | 1414 W Fair Ave, Suite 190, Marquette, MI 49855-2675 | 2006-07-21 |
| Find all providers in MARQUETTE | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.