Individual provider Active NPI

Heather Michelle O'Connor, D.O

  • Anatomic Pathology & Clinical Pathology Physician
  • Charleston, SC
National Provider Identifier
1619401221
Registry record updated Jan 20, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anatomic Pathology & Clinical Pathology PhysicianTaxonomy code 207ZP0102X
License
41033 Issued in SC
Practice address
169 Ashley Avenue Room 202
Main Hospital Msc333
Charleston, SC 29425
Phone
(843) 792-1086
NPI assigned
Apr 20, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 20, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Anatomic Pathology & Clinical Pathology Physician 207ZP0102X 41033 SC Primary

Addresses

Primary practice location

169 Ashley Avenue Room 202
Main Hospital Msc333
Charleston, SC 29425

Mailing address

PO Box 751461
Charlotte, NC 28275-1461
Phone (843) 792-6200

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address direct@direct.musc.edu Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in SC, MO2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20210630004163 SC Practitioner - Pathology 5799050993 Reassigns benefits to 1 organization
I20230627003279 MO Practitioner - Pathology 5799050993 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Pathology
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Southeast Missouri Hospital Physicians LLCGroup PAC ID 9133024334, 206 clinicians

Practice addresses (Care Compare)

1701 Lacey St
Cape Girardeau, MO 63701-5230
Phone (573) 334-4822

Hospital & facility affiliations

  • Mercy Hospital Southeast Hospital, Cape Girardeau, MO, CCN 260110
  • Missouri Delta Medical Center Hospital, Sikeston, MO, CCN 260113
  • Mercy Hospital Stoddard Hospital, Dexter, MO, CCN 260160

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
41033SCMDAnatomic Pathology & Clinical Pathology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
University Medical Associates of the Medical University of South Carol Current Accepting new patients
University Medical Associates of the Medical University of South Carol Anatomic Pathology & Clinical Pathology CurrentSince Jun 10, 2021 Accepting new patients
Southeast Missouri Hospital Physicians, LLC CurrentSince Jun 13, 2023 Accepting new patients

Locations

1701 Lacey St
Cpe Girardeau, MO 63701
Phone (573) 334-4822

169 Ashley Ave
Rm 202
Charleston, SC 29425
Phone (843) 792-0192

171 Ashley Ave
Charleston, SC 29425
Phone (843) 792-2123

606 Black River Rd
Georgetown, SC 29440
Phone (843) 527-7000

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.

Hospital & facility affiliations 3

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": "1492646400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1642636800000",
    "number": "1619401221",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 751461",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282751461",
            "telephone_number": "843-792-6200"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "169 ASHLEY AVENUE ROOM 202",
            "address_2": "MAIN HOSPITAL MSC333",
            "city": "CHARLESTON",
            "state": "SC",
            "postal_code": "29425",
            "telephone_number": "843-792-1086"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "O'CONNOR",
        "first_name": "HEATHER",
        "middle_name": "MICHELLE",
        "credential": "D.O",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-04-20",
        "last_updated": "2022-01-20",
        "certification_date": "2022-01-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207ZP0102X",
            "taxonomy_group": "",
            "desc": "Pathology, Anatomic Pathology & Clinical Pathology",
            "state": "SC",
            "license": "41033",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "direct@direct.musc.edu",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "169 Ashley Avenue Room 202",
            "address_2": "Main Hospital MSC333",
            "city": "Charleston",
            "state": "SC",
            "country_code": "US",
            "postal_code": "29425",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Charleston, SC

Sources for this page

Verify at the official NPI Registry.