Jason Robert Connelly, MD

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

200000386 Issued in NC

Practice address

335 School St
Cleveland, NC 27013-9501

Phone

(704) 210-7885

Fax

(704) 210-7898

NPI assigned

Aug 2, 2005

Sex

Male

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

Electronic endpoints 1

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: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Family Practice

Education

Wake Forest University School of Medicine, 1997

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Novant Health Medical Group, LLCGroup PAC ID 1153234893, 2,413 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Centerwell Home Health Home health agency, Kernersville, NC, CCN 347318
• Bayada Home Health Care, Inc Home health agency, Salisbury, NC, CCN 347325
• Novant Health Rowan Medical Center Hospital, Salisbury, NC, CCN 340015

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

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.

• Novant Health Medical Group, LLC

  • Endocrinology, Diabetes & Metabolism Physician
  • Charlotte, NC
  • NPI 1306950282

  NC

  Medicare reassignment Care Compare group NPD
• Novant Health Medical Group, LLC

  • Neurology with Special Qualifications in Child Neurology Physician
  • Charlotte, NC
  • NPI 1366409492

  NC

  Medicare reassignment Care Compare group NPD
• Novant Health Medical Group, LLC

  • Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
  • Charlotte, NC
  • NPI 1891764320

  NC

  Medicare reassignment Care Compare group
• NH Digital Health Services, LLC

  • Family Medicine Physician
  • Winston Salem, NC
  • NPI 1427683044

  Family Medicine, NC

  Medicare reassignment NPD
• Novant Health Medical Group, LLC

  • Foot & Ankle Surgery Podiatrist
  • Thomasville, NC
  • NPI 1235715582
  Care Compare group
• Novant Health Medical Group, LLC

  • Foot Surgery Podiatrist
  • Clemmons, NC
  • NPI 1295110906
  Care Compare group
• Novant Health Medical Group, LLC

  • Foot Surgery Podiatrist
  • Kernersville, NC
  • NPI 1386029254
  Care Compare group
• Novant Health Medical Group, LLC

  • Primary Podiatric Medicine Podiatrist
  • Winston Salem, NC
  • NPI 1427398023
  Care Compare group
• Novant Health Medical Group, LLC

  • Neurological Surgery Physician
  • Winston Salem, NC
  • NPI 1497080006
  Care Compare group
• Novant Health Medical Group, LLC

  • Family Medicine Physician
  • Wake Forest, NC
  • NPI 1659571768
  Care Compare group
• Novant Health Medical Group, LLC

  • Family Medicine Physician
  • Salisbury, NC
  • NPI 1750534038
  Care Compare group
• Novant Health Medical Group, LLC

  • Foot Surgery Podiatrist
  • Winston Salem, NC
  • NPI 1851776728
  Care Compare group

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Bayada Home Health Care, Inc.

  • Home Health Agency
  • Salisbury, NC
  • NPI 1508125816
  Care Compare affiliation
• Novant Health Rowan Medical Center LLC

  • General Acute Care Hospital
  • Salisbury, NC
  • NPI 1508843566

  Hospital

  Care Compare affiliation
• Total Care Home Health of North Carolina, LLC

  • Home Health Agency
  • Winston Salem, NC
  • NPI 1386672459
  Care Compare affiliation

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

{
    "created_epoch": "1122940800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1603843200000",
    "number": "1609877620",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 60447",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282600447"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "335 SCHOOL ST",
            "city": "CLEVELAND",
            "state": "NC",
            "postal_code": "270139501",
            "telephone_number": "704-210-7885",
            "fax_number": "704-210-7898"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CONNELLY",
        "first_name": "JASON",
        "middle_name": "ROBERT",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-08-02",
        "last_updated": "2020-10-28",
        "certification_date": "2020-09-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NC",
            "license": "200000386",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD NC",
            "identifier": "126RG",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "89126RG",
            "state": "NC"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "jconnelly15991@direct.novanthealth.org",
            "affiliation": "N",
            "address_1": "335 School St",
            "city": "Cleveland",
            "state": "NC",
            "country_code": "US",
            "postal_code": "270139501",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Diane Marie Caruso, FNP
• Cleveland Drug Company, Inc
• Cleveland Home Medical and Mobility
• Cleveland Home Medical and Mobility
• Cleveland Pediatrics PC
• Madelin Contreras
• Daniel Dwayne Day Jr.
• Hannah Lemckert Foster
• Paula Franklin, MD
• Shirley C Hampton

• All providers in Cleveland, NC
• Family Medicine Physician in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 28, 2020; 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.