Kathleen Oconnell

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

A11057 Issued in NC

Practice address

355 S Madison Blvd
Suite C
Roxboro, NC 27573

Phone

(336) 599-8366

NPI assigned

May 18, 2015

Last updated

Sep 4, 2018By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in NC

Eligible to order & refer

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

Green means eligible to order or refer.

Enrollment records 1

Specialty

Clinical Social Worker

Education

Other, 2014

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Mona R Gupta DO IncorporatedGroup PAC ID 8628386174, 24 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Mona R Gupta, DO Incorporated

  dba GPW Psychiatry

  • Psychiatry Physician
  • Raleigh, NC
  • NPI 1205134731
  Medicare reassignment Care Compare group NPD
• Mona R Gupta, DO Incorporated

  dba Gupta Wellness

  • Substance Use Disorder Rehabilitation Clinic/Center
  • Raleigh, NC
  • NPI 1225414352
  NPD

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

{
    "created_epoch": "1431907200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1536019200000",
    "number": "1710365192",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "355 S MADISON BLVD STE C",
            "city": "ROXBORO",
            "state": "NC",
            "postal_code": "275735485"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "355 S MADISON BLVD",
            "address_2": "SUITE C",
            "city": "ROXBORO",
            "state": "NC",
            "postal_code": "27573",
            "telephone_number": "336-599-8366"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OCONNELL",
        "first_name": "KATHLEEN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-05-18",
        "last_updated": "2018-09-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "NC",
            "license": "20850",
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "NC",
            "license": "A11057",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• North Carolina CVS Pharmacy LLC (CVS Pharmacy #03531)
• North Carolina Em I Medical Services P C
• North Carolina Eye Ear Nose & Throat PA (North Carolina Eye Ear Nose & Throat of Roxboro)
• North State Medical Center PA
• Elyse Bullock O'Connell, FNP
• Signe Offenberg
• William Bellamy Olds, MD
• Morgan T Orders, PA-C
• Jonelle Denise Palmer
• Paragon Outpatient Rehabilitation Services, LLC (Synchrony Rehab)

• Professional Counselor in Roxboro, NC
• Providers in Roxboro, NC by specialty
• Professional Counselor in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 4, 2018; 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.