Connie Winnie Chan, OD

Primary specialty

OptometristTaxonomy code 152W00000X

License

4531 Issued in MA

Practice address

139 Endicott St
Endicott Plaza, Mass Optometric Associates, P. C.
Danvers, MA 01923-4803

Phone

(978) 777-4700

Fax

(978) 750-0862

NPI assigned

Jul 14, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

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

{
    "created_epoch": "1152835200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1194566400000",
    "number": "1457377210",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2921 ERIE BLVD E",
            "address_2": "EMPIRE VISION CENTER, INC",
            "city": "SYRACUSE",
            "state": "NY",
            "postal_code": "132241430",
            "telephone_number": "315-446-3145",
            "fax_number": "315-445-7675"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "139 ENDICOTT ST",
            "address_2": "ENDICOTT PLAZA, MASS OPTOMETRIC ASSOCIATES, P. C.",
            "city": "DANVERS",
            "state": "MA",
            "postal_code": "019234803",
            "telephone_number": "978-777-4700",
            "fax_number": "978-750-0862"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHAN",
        "first_name": "CONNIE",
        "middle_name": "WINNIE",
        "name_prefix": "Dr.",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-14",
        "last_updated": "2007-11-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "MA",
            "license": "4531",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0703494",
            "state": "MA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "W16427",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Brittany Christine Cauley, B.A.
• Lauren Cernaro, M.S., CCC-SLP
• Sara Cerretani, LPTA
• Kelsey Chadwick, RD
• Allison Marie Chalmers
• Joan L Chane, NP
• Angela Chang, LICSW
• Rebecca J Chapman
• Chapters Recovery Center, Inc.
• Aubrey Ann Charles, LPN

• Optometrist in Danvers, MA
• Providers in Danvers, MA by specialty
• Optometrist in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 9, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.