NPIMap

Individual provider Active NPI

Camille Lauren Connelly, M.D.

  • Orthopaedic Surgery Physician
  • Mount Vernon, WA
National Provider Identifier
1194024448
Registry record updated Sep 30, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopaedic Surgery PhysicianTaxonomy code 207X00000X
License
MD60424676 Issued in WA
Practice address
901 S 5TH St
Mount Vernon, WA 98274-3942
Phone
(360) 424-7041
NPI assigned
Mar 24, 2011
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 30, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Orthopaedic Surgery Physician 207X00000X MD60424676 WA Primary
Orthopaedic Foot and Ankle Surgery Physician 207XX0004X MD60424676 WA

Addresses

Primary practice location

901 S 5TH St
Mount Vernon, WA 98274-3942

Mailing address

1400 E Kincaid St
Mount Vernon, WA 98274-4127

Other practice location 1

1401 S Laventure Rd
Mount Vernon, WA 98274-6033
Phone (360) 424-7041

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address cconnelly63363@skagit.direct-ci.com Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA
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
I20171013002502 WA Practitioner - Orthopedic Surgery 9931341781 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Orthopedic Surgery
Education
University of Washington School of Medicine, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Proliance Surgeons Inc P S 395 clinicians
Public Hospital Dist No 1 Skagit 321 clinicians

Practice addresses (Care Compare)

1401 S Laventure Rd
Mount Vernon, WA 98274-6033
Phone (360) 424-2400

901 S 5TH St
Mount Vernon, WA 98274-3942
Phone (360) 428-6434

Hospital & facility affiliations

  • Skagit Valley Hospital Hospital, Mount Vernon, WA, CCN 500003
  • Island Hospital Hospital, Anacortes, WA, CCN 500007
  • Whidbeyhealth Medical Center Hospital, Coupeville, WA, CCN 501339

Procedures performed for Medicare patients

ProcedureNumber of procedures
Hip replacement1-10
Knee replacement35
Lower limb (leg) arthroscopy (minimally invasive joint repair)1-10
Removal of tissue1-10
Removal of nail tissue1-10
Removal or shaving of skin growth1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MD60424676WAMDOrthopaedic Surgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Public Hospital Dist No 1 Skagit CurrentSince Sep 29, 2025 Accepting new patients
Proliance Surgeons, Inc., P.S. Orthopaedic Surgery CurrentSince Oct 2, 2017 Accepting new patients
Public Hospital Dist No 1 Skagit CurrentSince Sep 29, 2025 Accepting new patients
Public Hospital Dist No 1 Skagit Current Accepting new patients
Proliance Surgeons Inc P S Orthopaedic Surgery CurrentSince Oct 2, 2017 Accepting new patients
Proliance Surgeons Inc P S Orthopaedic Surgery Current Accepting new patients

Locations

1401 S Laventure Rd
Mount Vernon, WA 98274
Phone (360) 424-2400

1400 E Kincaid St
Mount Vernon, WA 98274
Phone (360) 428-2586

1500 Continental Pl
Mount Vernon, WA 98273
Phone (360) 424-7041

901 S 5th St
Mount Vernon, WA 98274
Phone (360) 428-6434

805 Madison St
Ste 901
Seattle, WA 98104
Phone (206) 264-8100

Interoperability endpoints

  • Direct secure messaging: camille.connelly.p15@direct.proliance.nextgenshare.com

Organizations & group practices 11

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 8

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": "1300924800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1759190400000",
    "number": "1194024448",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1400 E KINCAID ST",
            "city": "MOUNT VERNON",
            "state": "WA",
            "postal_code": "982744127"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "901 S 5TH ST",
            "city": "MOUNT VERNON",
            "state": "WA",
            "postal_code": "982743942",
            "telephone_number": "360-424-7041"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1401 S Laventure Rd",
            "address_purpose": "LOCATION",
            "city": "Mount Vernon",
            "state": "WA",
            "postal_code": "982746033",
            "country_code": "US",
            "telephone_number": "360-424-7041",
            "fax_number": "360-424-2456",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CONNELLY",
        "first_name": "CAMILLE",
        "middle_name": "LAUREN",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-03-24",
        "last_updated": "2025-09-30",
        "certification_date": "2025-09-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": "WA",
            "license": "MD60424676",
            "primary": true
        },
        {
            "code": "207XX0004X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery, Foot and Ankle Surgery",
            "state": "WA",
            "license": "MD60424676",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "cconnelly63363@skagit.direct-ci.com",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "901 S 5th St",
            "city": "Mount Vernon",
            "state": "WA",
            "country_code": "US",
            "postal_code": "982743942",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Mount Vernon, WA

Sources for this page

Verify at the official NPI Registry.