Individual provider Active NPI

Conner Jacob Thomson, PA-C

  • Physician Assistant
  • Cleveland, OH
National Provider Identifier
1124737242
Registry record updated May 10, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
Practice address
11100 Euclid Ave
Cleveland, OH 44106-1716
Phone
(216) 541-1758
NPI assigned
Nov 17, 2022
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 10, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X Primary

Addresses

Primary practice location

11100 Euclid Ave
Cleveland, OH 44106-1716

Mailing address

1999 Circle Dr Apt 337
Cleveland, OH 44106-3670

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240920001644 OH Practitioner - Physician Assistant 2567903206 Reassigns benefits to 3 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
University Hospitals Cleveland Medical Center Physician Assistant CurrentSince Jan 1, 2025 Accepting new patients
University Primary Care Practices Inc CurrentSince Sep 1, 2024 Accepting new patients
University Primary Care Practices Inc CurrentSince Sep 1, 2024 Accepting new patients
University Hospitals Cleveland Medical Center CurrentSince Jan 1, 2025 Accepting new patients
University Hospitals Medical Group Inc CurrentSince Sep 1, 2024 Accepting new patients

Locations

8055 Mayfield Rd
Ste 105
Chesterland, OH 44026
Phone (440) 214-8024

11100 Euclid Ave
Cleveland Heights, OH 44106

158 W Main Rd
Ste 203
Conneaut, OH 44030
Phone (440) 285-2960

Interoperability endpoints

  • Direct secure messaging: cthomson219990@ehrdirect.uhhospitals.org

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.

NPI Registry JSON

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

{
    "created_epoch": "1668643200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1683676800000",
    "number": "1124737242",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1999 CIRCLE DR APT 337",
            "city": "CLEVELAND",
            "state": "OH",
            "postal_code": "441063670"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11100 EUCLID AVE",
            "city": "CLEVELAND",
            "state": "OH",
            "postal_code": "441061716",
            "telephone_number": "216-541-1758"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "THOMSON",
        "first_name": "CONNER",
        "middle_name": "JACOB",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-11-17",
        "last_updated": "2023-05-10",
        "certification_date": "2023-05-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cleveland, OH

Sources for this page

Verify at the official NPI Registry.