NPIMap

Individual provider Active NPI

Connie J Borgerding, D.O.

  • Family Medicine Physician
  • Sylva, NC
National Provider Identifier
1669819355
Registry record updated Oct 27, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
89803 Issued in GA
Practice address
98 Doctors Dr Ste 200
Sylva, NC 28779-4502
Phone
(828) 588-9716
Fax
(828) 586-4083
NPI assigned
Jun 4, 2013
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 27, 2021

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 36080 SC
Family Medicine Physician 207Q00000X 2016-00355 NC
Student in an Organized Health Care Education/Training Program 390200000X
Family Medicine Physician 207Q00000X 89803 GA Primary

Addresses

Primary practice location

98 Doctors Dr Ste 200
Sylva, NC 28779-4502

Mailing address

1810 White Cir Ste 105
Marietta, GA 30066-5836
Phone (770) 420-1600

Other practice location 1

1810 White Cir Ste 105
Marietta, GA 30066-5836
Phone (770) 420-1600

Other identifiers 1

IdentifierTypeStateIssuer
360808MedicaidSC

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address cborgerding428757@directwellstar.org

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20210812001884 GA Practitioner - Family Practice 7810290806 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Philadelphia College of Osteopathic Medicine, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Wellstar Medical Group LLCGroup PAC ID 6709065402, 3,059 clinicians

Practice addresses (Care Compare)

1810 White Cir
Suite 105
Marietta, GA 30066-5836
Phone (678) 797-6820

5150 Stilesboro N W Rd
Suite 220
Kennesaw, GA 30152-7742
Phone (770) 424-8222

Hospital & facility affiliations

  • Wellstar Home Health, LLC Home health agency, Marietta, GA, CCN 117102
  • Community Home Health, an Amedisys Company Home health agency, Woodstock, GA, CCN 117130
  • Aveanna Home Health Home health agency, Smyrna, GA, CCN 117337
  • Wellstar Kennestone Regional Medical Center Hospital, Marietta, GA, CCN 110035
  • Wellstar Cobb Medical Center Hospital, Austell, GA, CCN 110143
  • Wellstar Paulding Medical Center Hospital, Hiram, GA, CCN 110042
  • Northside Hospital Hospital, Atlanta, GA, CCN 110161
  • Wellstar Windy Hill Hospital Long-term care hospital, Marietta, GA, CCN 112007

Merit-based Incentive Payment System (MIPS)

Final score
93.93 of 100Reported as apm
Quality
82.14
Promoting interoperability
100
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
2016-00355NCMDFamily Medicine Physician
36080SCMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Wellstar Medical Group, LLC CurrentSince Aug 15, 2021 Accepting new patients
Wellstar Medical Group, LLC Family Medicine Current Accepting new patients

Locations

5150 Stilesboro Rd NW
Ste 220
Kennesaw, GA 30152
Phone (770) 424-8222

1810 White Cir
Ste 105
Marietta, GA 30066
Phone (678) 797-6820

805 Sandy Plains Rd
Marietta, GA 30066
Phone (770) 792-1616

Interoperability endpoints

  • Direct secure messaging: cborgerding428757@directwellstar.org

Organizations & group practices 2

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 8

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": "1370304000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1635292800000",
    "number": "1669819355",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1810 WHITE CIR STE 105",
            "city": "MARIETTA",
            "state": "GA",
            "postal_code": "300665836",
            "telephone_number": "770-420-1600",
            "fax_number": "770-999-2802"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "98 DOCTORS DR STE 200",
            "city": "SYLVA",
            "state": "NC",
            "postal_code": "287794502",
            "telephone_number": "828-588-9716",
            "fax_number": "828-586-4083"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1810 White Cir Ste 105",
            "address_purpose": "LOCATION",
            "city": "Marietta",
            "state": "GA",
            "postal_code": "300665836",
            "country_code": "US",
            "telephone_number": "770-420-1600",
            "fax_number": "770-999-2802",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BORGERDING",
        "first_name": "CONNIE",
        "middle_name": "J",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-06-04",
        "last_updated": "2021-10-27",
        "certification_date": "2021-10-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "SC",
            "license": "36080",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NC",
            "license": "2016-00355",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "GA",
            "license": "89803",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "360808",
            "state": "SC"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "cborgerding428757@directwellstar.org",
            "affiliation": "N",
            "address_1": "1810 White Cir Ste 105",
            "city": "Marietta",
            "state": "GA",
            "country_code": "US",
            "postal_code": "300665836",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Sylva, NC

Sources for this page

Verify at the official NPI Registry.