NPIMap

Individual provider Active NPI

Randi Shae Connor, M.D.

  • Gynecologic Oncology Physician
  • Chattanooga, TN
National Provider Identifier
1073801965
Registry record updated Jun 26, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gynecologic Oncology PhysicianTaxonomy code 207VX0201X
License
57517 Issued in TN
Practice address
102 Central Ave
Chattanooga, TN 37403
Phone
(423) 266-3636
Fax
(423) 266-3633
NPI assigned
Jul 13, 2011
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 26, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Gynecologic Oncology Physician 207VX0201X 57517 TN Primary

Addresses

Primary practice location

102 Central Ave
Chattanooga, TN 37403

Mailing address

102 Central Ave
Chattanooga, TN 37403-1503
Phone (423) 266-3636

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TN
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20180814002438 TN Practitioner - Gynecological Oncology 9032349212 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Gynecological Oncology
Education
Other, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Chattanooga Hamilton County Hospital AuthorityGroup PAC ID 0547179731, 159 clinicians
Erlanger HealthGroup PAC ID 1153780226, 504 clinicians

Practice addresses (Care Compare)

102 Central Ave
Chattanooga, TN 37403-1503
Phone (423) 266-3636

Hospital & facility affiliations

  • Amedisys Home Health Chattanooga Home health agency, Chattanooga, TN, CCN 447156
  • Erlanger Medical Center Hospital, Chattanooga, TN, CCN 440104
  • Memorial Healthcare System, Inc Hospital, Chattanooga, TN, CCN 440091
  • Parkridge Medical Center Hospital, Chattanooga, TN, CCN 440156

Merit-based Incentive Payment System (MIPS)

Final score
93.78 of 100Reported as apm
Quality
80.38
Promoting interoperability
100
Improvement activities
40

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of the uterus16

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Erlanger Health CurrentSince Jul 1, 2023 Accepting new patients
Chattanooga Hamilton County Hospital Authority CurrentSince Jun 13, 2018 Accepting new patients
Erlanger Health CurrentSince Jul 1, 2023 Accepting new patients
Chattanooga Hamilton County Hospital Authority CurrentSince Jun 13, 2018 Accepting new patients
Erlanger Health Past Accepting new patients
Erlanger Health Past Accepting new patients

Locations

102 Central Ave
Chattanooga, TN 37403
Phone (423) 266-3636

975 E 3rd St
Chattanooga, TN 37403
Phone (423) 266-1499

2600 Taft Hwy
Ste 100
Signal Mtn, TN 37377
Phone (423) 778-9434

Interoperability endpoints

  • Direct secure messaging: randi.connor.1@633.direct.athenahealth.com

Organizations & group practices 6

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.

Hospital & facility affiliations 5

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

NPI Registry JSON

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

{
    "created_epoch": "1310515200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1529971200000",
    "number": "1073801965",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "102 CENTRAL AVE",
            "city": "CHATTANOOGA",
            "state": "TN",
            "postal_code": "374031503",
            "telephone_number": "423-266-3636",
            "fax_number": "423-266-3633"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "102 CENTRAL AVE",
            "city": "CHATTANOOGA",
            "state": "TN",
            "postal_code": "37403",
            "telephone_number": "423-266-3636",
            "fax_number": "423-266-3633"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CONNOR",
        "first_name": "RANDI",
        "middle_name": "SHAE",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-07-13",
        "last_updated": "2018-06-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207VX0201X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology, Gynecologic Oncology",
            "state": "TN",
            "license": "57517",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chattanooga, TN

Sources for this page

Verify at the official NPI Registry.