Active NPI
Connor Sholtis
- Orthopaedic Surgery Physician
- Redwood City, CA
National Provider Identifier
1477132231
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Orthopaedic Surgery Physician
- License
- A197736
- Practice address
- 430 Broadway St, MC: 6342
Pavilion C, 4TH Floor
Redwood City, CA 94063-3132 - Phone
- (650) 721-7638
- NPI assigned
- Apr 7, 2021
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Orthopaedic Surgery Physician | 207X00000X | A197736 | CA | Primary |
Addresses
Primary practice location
430 Broadway St, MC: 6342
Pavilion C, 4TH Floor
Redwood City, CA 94063-3132
Mailing address
430 Broadway St, MC: 6342
Pavilion C, 4TH Floor
Redwood City, CA 94063-3132
Phone (650) 721-7638
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| A197736 | CA | MD | Orthopaedic Surgery Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1617753600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1729468800000",
"number": "1477132231",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "430 BROADWAY ST, MC: 6342",
"address_2": "PAVILION C, 4TH FLOOR",
"city": "REDWOOD CITY",
"state": "CA",
"postal_code": "940633132",
"telephone_number": "650-721-7638"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "430 BROADWAY ST, MC: 6342",
"address_2": "PAVILION C, 4TH FLOOR",
"city": "REDWOOD CITY",
"state": "CA",
"postal_code": "940633132",
"telephone_number": "650-721-7638"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SHOLTIS",
"first_name": "CONNOR",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2021-04-07",
"last_updated": "2024-10-21",
"certification_date": "2024-10-21",
"status": "A"
},
"taxonomies": [
{
"code": "207X00000X",
"taxonomy_group": "",
"desc": "Orthopaedic Surgery",
"state": "CA",
"license": "A197736",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Redwood City, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 21, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.