John Thomas Connelly III, PA-C

Primary specialty

Surgical Physician AssistantTaxonomy code 363AS0400X

License

4532 Issued in SC

Practice address

145 Park Central Dr Ste 100
Columbia, SC 29203-6469

Phone

(803) 736-3277

Fax

(803) 408-8698

NPI assigned

Apr 26, 2013

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in SC

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

Specialty

Physician Assistant

Education

Other, 2012

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

South Carolina ENT Allergy and Sleep Medicine PAGroup PAC ID 0840214748, 24 clinicians

Practice addresses (Care Compare)

Merit-based Incentive Payment System (MIPS)

Final score

84.09 of 100Reported as group

Quality

68.87

Promoting interoperability

100

Improvement activities

40

Cost

78.11

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: jconnelly96971@mhsdirect.net

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.

• South Carolina ENT Allergy & Sleep Medicine PA

  • Otolaryngology Physician
  • Lugoff, SC
  • NPI 1134153083

  SC

  Medicare reassignment Care Compare group
• Lexington Health Inc

  • Sports Medicine (Orthopaedic Surgery) Physician
  • West Columbia, SC
  • NPI 1710634753

  SC

  Medicare reassignment
• Lexington Health Inc

  • Internal Medicine Physician
  • West Columbia, SC
  • NPI 1942190988
  NPD
• Lexington Health, Inc

  • Ophthalmology Physician
  • West Columbia, SC
  • NPI 1891444121
  NPD

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

{
    "created_epoch": "1366934400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1725408000000",
    "number": "1164866646",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "500 NORTHRIDGE RD STE 400",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303503314",
            "telephone_number": "803-736-3277"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "145 PARK CENTRAL DR STE 100",
            "city": "COLUMBIA",
            "state": "SC",
            "postal_code": "292036469",
            "telephone_number": "803-736-3277",
            "fax_number": "803-408-8698"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1150 N. 35th Avenue",
            "address_2": "Suite 490",
            "address_purpose": "LOCATION",
            "city": "Hollywood",
            "state": "FL",
            "postal_code": "33021",
            "country_code": "US",
            "telephone_number": "954-265-1616",
            "fax_number": "954-893-6325",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "146 E Hospital Dr Ste 200",
            "address_purpose": "LOCATION",
            "city": "West Columbia",
            "state": "SC",
            "postal_code": "291694800",
            "country_code": "US",
            "telephone_number": "803-936-7530",
            "fax_number": "803-936-7532",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CONNELLY",
        "first_name": "JOHN",
        "middle_name": "THOMAS",
        "name_prefix": "Mr.",
        "name_suffix": "III",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-04-26",
        "last_updated": "2024-09-04",
        "certification_date": "2024-09-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "FL",
            "license": "PA9106938",
            "primary": false
        },
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "SC",
            "license": "4532",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "jconnelly96971@MHSDIRECT.NET",
            "affiliation": "N",
            "endpointDescription": "MHS DSM",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "1150 N. 35th Avenue",
            "address_2": "Suite 490",
            "city": "Hollywood",
            "state": "FL",
            "country_code": "US",
            "postal_code": "33021",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Jennifer Conjura
• Rachel Conklin
• Connecting Dots Counseling Services LLC
• Connecting Health Innovations LLC
• Connection Place
• James Nicholas Conner, DO
• Mariah Elaine Conner, MSW, LCSW, LISW-CP
• Sarah Lee Conner
• Susan Connolly-Nelson Lisw, LISW
• Cody Jerome Connor, M.D.

• All providers in Columbia, SC
• Surgical Physician Assistant in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 4, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.