DR. KEVIN MARK CONNOLLY (NPI# 1821229360) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1821229360 |
| Entity Type | Individual |
| Full Name | DR. KEVIN MARK CONNOLLY |
| Credential | PH.D. |
| Practice Address |
1500 E Woodrow Wilson Ave (116a2) Jackson MS 39216-5116 |
| Practice Telephone | 6013624471 |
| Mailing Telephone | 6013624471 |
| Enumeration Date | 2009-07-31 |
| Last Update Date | 2013-08-19 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 103TC0700X |
Psychologist Specialization: Clinical |
49845 | MS | Behavioral Health & Social Service Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1457373391 | Kevin F Connolly | Psychiatry & Neurology | 404-b Black Hills Ln Sw, Olympia, WA 98502-8148 | 2006-07-23 |
| 1649233560 | Kevin Patrick Connolly | Family Medicine | Psc 76 Box 4861, Apo, AP 96319-0027 | 2006-04-11 |
| 1710502182 | Kevin Connolly | Student in an Organized Health Care Education/Training Program | 15 E Chestnut St, Augusta, ME 04330-5736 | 2020-06-11 |
| 1841848744 | Kevin James Connolly | Speech-Language Pathologist | 99 Hollywood Dr, Smithtown, NY 11787-3135 | 2019-09-04 |
| 1699260737 | Kevin Connolly | Physician Assistant | 326 Washington St, Norwich, CT 06360-2740 | 2018-06-29 |
| 1104352764 | Kevin Connolly | Student in an Organized Health Care Education/Training Program | 500 S Preston St Rm 305, Louisville, KY 40202-1702 | 2017-05-02 |
| 1215314257 | Kevin Patrick Connolly | Pediatrics | 2823 Fresno St, Fresno, CA 93721-1324 | 2015-04-28 |
| 1124419643 | Kevin Connolly | Counselor | 1 Tiffany Pt Ste 110, Bloomingdale, IL 60108-2915 | 2015-02-06 |
| 1841633948 | Kevin Connolly | Internal Medicine | 1310 Las Tablas Rd Ste 103, Templeton, CA 93465 | 2013-04-09 |
| 1073731808 | Kevin M. Connolly | Chiropractor | 900 Jorie Blvd, Suite 104, Oak Brook, IL 60523-2213 | 2007-04-24 |
| Street Address |
1500 E WOODROW WILSON AVE (116A2) |
| City | JACKSON |
| State | MS |
| Zip Code | 39216-5116 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1740264035 | Sadeka Tamanna | Internal Medicine | 1500 E Woodrow Wilson Ave, Jackson, MS 39216-5116 | 2005-12-01 |
| 1881291383 | Regina Marie Riley | Recreation Therapist | 1500 E Woodrow Wilson Ave, Jackson, MS 39216-5116 | 2020-10-07 |
| 1811502024 | Wendy Hopkins | Registered Nurse | 1500 E Woodrow Wilson Ave, Jackson, MS 39216-5116 | 2020-09-14 |
| 1528679420 | Christopher Michael Mcguffey | Physical Therapist | 1500 E Woodrow Wilson Ave, Jackson, MS 39216-5116 | 2020-08-13 |
| 1124637319 | Kathryn Martin Lewis | Registered Nurse | 1500 E Woodrow Wilson Ave, Jackson, MS 39216-5116 | 2020-07-24 |
| 1932727468 | Davis Mckenna Simms | Recreation Therapist | 1500 E Woodrow Wilson Ave, Jackson, MS 39216-5116 | 2020-07-10 |
| 1154948222 | Tiffany Floyd | Recreation Therapist | 1500 E Woodrow Wilson Ave, Jackson, MS 39216-5116 | 2020-07-06 |
| 1962029389 | Devonda Y Elliott | Recreation Therapist | 1500 E Woodrow Wilson Ave, Jackson, MS 39216-5116 | 2020-07-01 |
| 1629693759 | Latorya Lashay Smith | Dietitian, Registered | 1500 E Woodrow Wilson Ave, Jackson, MS 39216-5116 | 2020-06-15 |
| 1932721669 | Aubrey Cain Young | Pharmacist | 1500 E Woodrow Wilson Ave, Jackson, MS 39216-5116 | 2020-05-15 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1861011553 | Ashley Melancon Prewitt | Registered Nurse | St. Dominic's North Campus, Behavioral Health, Jackson, MS 39216 | 2020-04-13 |
| 1194353391 | Brianna Arrington | Student in an Organized Health Care Education/Training Program | Med/ Peds, 2500 N. State St., Jackson, MS 39216 | 2020-04-01 |
| 1720616485 | Roshina Khalid Khan | Student in an Organized Health Care Education/Training Program | Department of Anesthesiology, Ummc, 2500 N. State St., Jackson, MS 39216 | 2020-03-30 |
| 1275183550 | Amanda Lynn Morellato | Dentist | Ummc School of Dentistry, 2500 North State Street, Jackson, MS 39216 | 2019-09-18 |
| 1396305553 | Abhishek Chhabra | Student in an Organized Health Care Education/Training Program | Lakeland Family Medicine Clinic, 878 Lakeland Dr., Jackson, MS 39216 | 2019-06-19 |
| 1427615996 | Hometown Diagnostics | Clinical Medical Laboratory | Translational Research Center Tr311, 2500 North State Street, Jackson, MS 39216 | 2019-05-21 |
| 1346807773 | Shukundala C Smith | Behavior Technician | New Learning Resources 2510 Lakeland Terrace, Jackson, MS 39216 | 2019-05-21 |
| 1063901098 | G Eli Howell Md Pllc | Plastic Surgery | 971 Lakeland Dr Ste 225, Jackson, MS 39216 | 2018-05-04 |
| 1588168132 | Caleb Zumbro | Student in an Organized Health Care Education/Training Program | Ummc Med/peds, 2500 N. State St., Jackson, MS 39216 | 2018-03-20 |
| 1639677230 | Walgreen Co | Pharmacy | 971 Lakeland Dr Ste 101, Jackson, MS 39216 | 2018-01-29 |
| Find all providers in zip 39216 | ||||
| Taxonomy Code | 103TC0700X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Psychologist |
| Specialization | Clinical |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1043756174 | Maribeth L. Hesser | Psychologist | 6675 N Upper Cascade Dr, Jackson, WY 83001-9390 | 2017-01-12 |
| 1215375746 | Payne Behavioral Medicine | Psychologist | 4005 N State St Ste N, Jackson, MS 39206-5755 | 2013-06-06 |
| 1598002610 | Kimberly D Weaver | Psychologist | 207 First Street, Jackson, MI 49201 | 2013-01-09 |
| 1497027775 | Fitness Clinic | Psychologist | 2219 Greenway Dr, Jackson, MS 39204-3202 | 2012-02-02 |
| 1760752976 | Mitchell S. Weisbrod, Psy.d., Pllc | Psychologist | 115 S West Ave Ste 1, Jackson, MI 49201-2085 | 2012-01-04 |
| 1275830887 | Martin E Cleveland Phd Pllc | Psychologist | 5 Brentmeade Cv, Jackson, TN 38305-6448 | 2011-02-16 |
| 1154636611 | Shannon Monique Moore | Psychologist | 1675 Lakeland Dr Ste 304, Jackson, MS 39216 | 2010-08-09 |
| 1598076903 | Nanetta S Payne | Psychologist | 4005 N State St, Suite N, Jackson, MS 39206-5755 | 2010-06-30 |
| 1932422763 | Marion Counseling Services, Pllc | Psychologist | 2095 Dunbarton Dr, Suite 103, Jackson, MS 39216-5017 | 2010-03-08 |
| 1457548737 | Deborah Ruddy Hansen | Psychologist | 6 Universal Way, Jackson, MI 49202-1455 | 2007-10-01 |
| Find all providers in JACKSON | ||||
Please comment or provide details below to improve the information on DR. KEVIN MARK CONNOLLY.
| 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.