Kelsey Terese McConnell, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

5601007499 Issued in MI

Practice address

416 Connable Ave
Petoskey, MI 49770-2212

Phone

(800) 248-6777

NPI assigned

Sep 10, 2015

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in MI

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 1

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: kelsey.mcconnell@1152.chartlogic.direct-ci.com

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.

• Bay Street Orthopaedics PLLC

  • Orthopaedic Surgery Physician
  • Petoskey, MI
  • NPI 1174808992

  MI

  Medicare reassignment NPD

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

{
    "created_epoch": "1441843200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1477958400000",
    "number": "1669840450",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3660 RESORT PIKE RD",
            "city": "PETOSKEY",
            "state": "MI",
            "postal_code": "497709228",
            "telephone_number": "989-339-4688"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "416 CONNABLE AVE",
            "city": "PETOSKEY",
            "state": "MI",
            "postal_code": "497702212",
            "telephone_number": "800-248-6777"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCCONNELL",
        "first_name": "KELSEY",
        "middle_name": "TERESE",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-09-10",
        "last_updated": "2016-11-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MI",
            "license": "5601007499",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Daina Leigh Sutton McAdams
• Melanie Elizabeth McArthur, MS, OTRL
• Laurie Hope McCaslin, D.C.
• Kaitlyn Marie McCauley
• Susan McCloskey
• Elizabeth McCormack, LMSW
• Luke McCrone, MD
• Jeffrey Hans McDonald
• Daniel E McDonnell, M.D.
• Dennis Edward McGeath, M.D.

• All providers in Petoskey, MI
• Physician Assistant in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 1, 2016; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.