Connor Charles Balderston

Primary specialty

Community Health WorkerTaxonomy code 172V00000X

License

106650 Issued in OR

Practice address

151 W 7TH Ave
Suite #310
Eugene, OR 97401

Phone

(541) 682-4041

Fax

(541) 682-2455

NPI assigned

Aug 4, 2022

Last updated

Aug 17, 2022By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Interoperability endpoints

• Direct secure messaging: connor.balderson.p1@direct.lanecounty.nextgenshare.com

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

{
    "created_epoch": "1659571200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1660694400000",
    "number": "1710614201",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "151 W 7TH AVE",
            "address_2": "SUITE #310",
            "city": "EUGENE",
            "state": "OR",
            "postal_code": "97401",
            "telephone_number": "541-682-4041",
            "fax_number": "541-682-2455"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "151 W 7TH AVE",
            "address_2": "SUITE #310",
            "city": "EUGENE",
            "state": "OR",
            "postal_code": "97401",
            "telephone_number": "541-682-4041",
            "fax_number": "541-682-2455"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BALDERSTON",
        "first_name": "CONNOR",
        "middle_name": "CHARLES",
        "name_prefix": "Mr.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2022-08-04",
        "last_updated": "2022-08-17",
        "certification_date": "2022-08-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "172V00000X",
            "taxonomy_group": "",
            "desc": "Community Health Worker",
            "state": "OR",
            "license": "106650",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Micah Lee Baker, PTA
• Sara Lynn Baker
• Scott G Baker, DMD
• Laura Bakkensen
• Aidan Balbona, RN
• Jorney Oceana Baldwin Chee
• Valerie Baldwin-Thomas, APRN, ACNP, PMHNP-BC
• Chantelle Marie Baldwin, DO, ND
• David V. Baldwin, PHD
• Haley D Bales, M. ED., LMFT

• Community Health Worker in Eugene, OR
• Providers in Eugene, OR by specialty
• Community Health Worker in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 17, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.