Active NPI
Conner Ellis Brannan, PA-C
- Medical Physician Assistant
- Raleigh, NC
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Medical Physician Assistant
- License
- 0010-13475
- Practice address
- 3000 New Bern Ave
Raleigh, NC 27610-1231 - Phone
- (919) 350-8000
- NPI assigned
- May 15, 2023
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Medical Physician Assistant | 363AM0700X | 0010-13475 | NC | Primary |
| Physician Assistant | 363A00000X | 0010-13475 | NC | |
| Student in an Organized Health Care Education/Training Program | 390200000X |
Addresses
Primary practice location
3000 New Bern Ave
Raleigh, NC 27610-1231
Mailing address
6197 Beale Loop
Raleigh, NC 27616-3483
Phone (336) 409-4461
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: No
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Physician Assistant
- Education
- Other, 2023
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
10000 Falls of Neuse Rd
Raleigh, NC 27614-7838
Phone (919) 350-8000
3000 New Bern Ave
Raleigh, NC 27610-1231
Phone (919) 350-7270
Hospital & facility affiliations
- Wakemed, Raleigh Campus
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 0010-13475 | NC | MD | Physician Assistant |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Wakemed Specialists Group LLC | Current | Accepting new patients | |
| Wakemed Specialists Group LLC | Current | Accepting new patients |
Locations
3000 New Bern Ave
Raleigh, NC 27610
Phone (919) 350-7000
Organizations & group practices 3
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.
-
- Cardiovascular Disease Physician
- Raleigh, NC
- NPI 1588227839
-
- Cardiac Rehabilitation Registered Nurse
- Raleigh, NC
- NPI 1063304228
-
- Maternal & Fetal Medicine Physician
- Raleigh, NC
- NPI 1518521905
Hospital & facility affiliations 2
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- Psychiatric Hospital Unit
- Raleigh, NC
- NPI 1780446302
-
- General Acute Care Hospital
- Raleigh, NC
- NPI 1972579837
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1684108800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1701388800000",
"number": "1245920040",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "6197 BEALE LOOP",
"city": "RALEIGH",
"state": "NC",
"postal_code": "276163483",
"telephone_number": "336-409-4461"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3000 NEW BERN AVE",
"city": "RALEIGH",
"state": "NC",
"postal_code": "276101231",
"telephone_number": "919-350-8000"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BRANNAN",
"first_name": "CONNER",
"middle_name": "ELLIS",
"name_prefix": "Mr.",
"credential": "PA-C",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2023-05-15",
"last_updated": "2023-12-01",
"certification_date": "2023-12-01",
"status": "A"
},
"taxonomies": [
{
"code": "363AM0700X",
"taxonomy_group": "",
"desc": "Physician Assistant, Medical",
"state": "NC",
"license": "0010-13475",
"primary": true
},
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "NC",
"license": "0010-13475",
"primary": false
},
{
"code": "390200000X",
"taxonomy_group": "",
"desc": "Student in an Organized Health Care Education/Training Program",
"state": null,
"license": null,
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Raleigh, NC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 1, 2023; 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.