Stephanie Noelle Connely, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

15-02568 Issued in KS

Practice address

2577 Main Ave
Durango, CO 81301

Phone

(970) 247-8382

Fax

(970) 259-4403

NPI assigned

Jul 27, 2018

Sex

Female

Sole proprietor

No

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

Specialties & licenses 4

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in KS, MO2 enrollments

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 2

Specialty

Physician Assistant

Education

Other, 2018

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

United Imaging Consultants LLCGroup PAC ID 4486545498, 33 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Lee's Summit Medical Center Hospital, Lees Summit, MO, CCN 260190
• Centerpoint Medical Center Hospital, Independence, MO, CCN 260095
• Menorah Medical Center Hospital, Overland Park, KS, CCN 170182

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

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.

• United Imaging Consultants, LLC

  • Diagnostic Radiology Physician
  • Lenexa, KS
  • NPI 1588669766

  MO

  Medicare reassignment Care Compare group NPD
• Emergency Medicine Services of Mo, LLC

  • Emergency Medicine Physician
  • Independence, MO
  • NPI 1023715182
  Medicare reassignment
• Kansas Carenow Urgent Care LLC

  • Urgent Care Clinic/Center
  • Leawood, KS
  • NPI 1255883682

  MO

  Medicare reassignment
• Carespot Professional Services LLC

  dba CareNow

  • Urgent Care Clinic/Center
  • Overland Park, KS
  • NPI 1568703783
  NPD (past)

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

• Centerpoint Medical Center of Independence, LLC

  dba Centerpoint Medical Center

  • General Acute Care Hospital
  • Independence, MO
  • NPI 1942247044
  Care Compare affiliation
• Midwest Division - LSH, LLC

  dba Lee's Summit Medical Center

  • General Acute Care Hospital
  • Lee's Summit, MO
  • NPI 1225085871
  Care Compare affiliation
• Midwest Division - MMC, LLC

  dba Menorah Medical Center

  • General Acute Care Hospital
  • Overland Park, KS
  • NPI 1255378337
  Care Compare affiliation

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

{
    "created_epoch": "1532649600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1644451200000",
    "number": "1639656085",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17700 E 39TH ST S",
            "city": "INDEPENDENCE",
            "state": "MO",
            "postal_code": "640556725",
            "telephone_number": "163-930-2508"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2577 MAIN AVE",
            "city": "DURANGO",
            "state": "CO",
            "postal_code": "81301",
            "telephone_number": "970-247-8382",
            "fax_number": "970-259-4403"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "875 Pre Emption Rd",
            "address_purpose": "LOCATION",
            "city": "Geneva",
            "state": "NY",
            "postal_code": "144562042",
            "country_code": "US",
            "telephone_number": "315-789-5061",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "604 S Rio Grande Ave",
            "address_purpose": "LOCATION",
            "city": "Aztec",
            "state": "NM",
            "postal_code": "874102260",
            "country_code": "US",
            "telephone_number": "505-334-2664",
            "fax_number": "505-334-7759",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "17700 E 39th St S",
            "address_purpose": "LOCATION",
            "city": "Independence",
            "state": "MO",
            "postal_code": "640556725",
            "country_code": "US",
            "telephone_number": "816-393-0250",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CONNELY",
        "first_name": "STEPHANIE",
        "middle_name": "NOELLE",
        "name_prefix": "Mrs.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-07-27",
        "last_updated": "2022-02-10",
        "certification_date": "2022-02-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MO",
            "license": "2018017096",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NY",
            "license": "022356-1",
            "primary": false
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "CO",
            "license": "PA.0005871",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "KS",
            "license": "15-02568",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NONE",
            "identifier": "NONE",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Janiece T Commanche
• Community Connections Inc.
• Community Connections Inc.
• Community Connections Inc.
• Renee Compagna, LMT
• Russelyn William Connor, RN
• Richard L Converse Jr., MD
• W Donald Cooke, MD
• Sydney Lynn Cooley, L. AC
• Joshua Coon, EDD

• Physician Assistant in Durango, CO
• Providers in Durango, CO by specialty
• Physician Assistant in Colorado

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 10, 2022; 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.