Individual provider Active NPI

Chelsea Amanda Connor, M.D.

  • Surgery Physician
  • Greensboro, NC
National Provider Identifier
1104187327
Registry record updated Jun 16, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
License
2017-00723 Issued in NC
Practice address
1002 N Church St Ste 302
Greensboro, NC 27401-1449
Phone
(336) 387-8100
Fax
(336) 387-8202
NPI assigned
Jun 5, 2012
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 16, 2018

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X MMD.34738 LL SC
Surgery Physician 208600000X 2017-00723 NC Primary

Addresses

Primary practice location

1002 N Church St Ste 302
Greensboro, NC 27401-1449

Mailing address

1002 N Church St Ste 302
Greensboro, NC 27401-1449
Phone (336) 387-8100

Other practice location 1

169 Ashley Ave
Room 202 Main Hospital, MSC333
Charleston, SC 29425-8905
Phone (843) 792-4638

Other identifiers 1

IdentifierTypeStateIssuer
1104187327MedicaidNC

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC
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

Enrollment IDStateProvider typePAC IDDetails
I20170814000575 NC Practitioner - General Surgery 6709007214 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
General Surgery
Education
University of Florida College of Medicine, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Duke Health Integrated Practice IncGroup PAC ID 8325412737, 3,140 clinicians

Practice addresses (Care Compare)

1002 N Church St
Greensboro, NC 27401-1439
Phone (919) 684-8111

40 Duke Medicine Cir
Durham, NC 27710-4000
Phone (919) 684-8111

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Colonoscopy1-10
Hernia repair - groin (open)1-10
Hernia repair (minimally invasive)1-10
Upper gastrointestinal (GI) endoscopy for acid reflux1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MMD.34738 LLSCMDSurgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Duke Health Integrated Practice, Inc. CurrentSince Jul 1, 2023 Accepting new patients

Locations

2905 Crouse Ln
Ste 201
Burlington, NC 27215
Phone (336) 387-8100

40 Duke Medicine Cir
Durham, NC 27710
Phone (919) 681-6588

1126 N Church St
Ste 203
Greensboro, NC 27401
Phone (336) 235-0944

1002 N Church St
Greensboro, NC 27401
Phone (336) 379-7413

1002 N Church St
Ste 302
Greensboro, NC 27401
Phone (336) 387-8100

Interoperability endpoints

  • Direct secure messaging: cconnor515566@direct.medicine.duke.edu
  • Direct secure messaging: chelseaconnor@ccspa.allscriptsdirect.net

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 1

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": "1338854400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1529107200000",
    "number": "1104187327",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1002 N CHURCH ST STE 302",
            "city": "GREENSBORO",
            "state": "NC",
            "postal_code": "274011449",
            "telephone_number": "336-387-8100",
            "fax_number": "336-387-8202"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1002 N CHURCH ST STE 302",
            "city": "GREENSBORO",
            "state": "NC",
            "postal_code": "274011449",
            "telephone_number": "336-387-8100",
            "fax_number": "336-387-8202"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "169 Ashley Ave",
            "address_2": "Room 202 Main Hospital, MSC333",
            "address_purpose": "LOCATION",
            "city": "Charleston",
            "state": "SC",
            "postal_code": "294258905",
            "country_code": "US",
            "telephone_number": "843-792-4638",
            "fax_number": "843-792-3315",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CONNOR",
        "first_name": "CHELSEA",
        "middle_name": "AMANDA",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-06-05",
        "last_updated": "2018-06-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "SC",
            "license": "MMD.34738 LL",
            "primary": false
        },
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "NC",
            "license": "2017-00723",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1104187327",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Greensboro, NC

Sources for this page

Verify at the official NPI Registry.