Active NPI
Connie S Canaday, FNP
- Nurse Practitioner
- Charleston, SC
National Provider Identifier
1831273481
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Nurse Practitioner
- License
- 3688
- Practice address
- Musc Hollings Cancer Ctr
86 Jonathan Lucas St.
Charleston, SC 29425-0001 - Phone
- (843) 792-9300
- Fax
- (843) 792-1445
- NPI assigned
- Oct 24, 2006
- Last updated
- Jan 4, 2021
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Nurse Practitioner | 363L00000X | 3688 | SC | Primary |
Addresses
Primary practice location
Musc Hollings Cancer Ctr
86 Jonathan Lucas St.
Charleston, SC 29425-0001
Mailing address
PO Box 751461
Charlotte, NC 28275-1461
Phone (843) 792-6200
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| GP2128 | Medicaid | SC |
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | ccanaday3984@direct.musc.edu | Direct |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 3688 | SC | MD | Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| MCV Associated Physicians | Past | Accepting new patients |
Interoperability endpoints
- ccanaday3984@direct.musc.edu
Organizations & group practices 1
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.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1161648000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1609718400000",
"number": "1831273481",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 751461",
"city": "CHARLOTTE",
"state": "NC",
"postal_code": "282751461",
"telephone_number": "843-792-6200"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "MUSC HOLLINGS CANCER CTR",
"address_2": "86 JONATHAN LUCAS ST.",
"city": "CHARLESTON",
"state": "SC",
"postal_code": "294250001",
"telephone_number": "843-792-9300",
"fax_number": "843-792-1445"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CANADAY",
"first_name": "CONNIE",
"middle_name": "S",
"name_prefix": "Ms.",
"credential": "FNP",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-10-24",
"last_updated": "2021-01-04",
"certification_date": "2021-01-04",
"status": "A"
},
"taxonomies": [
{
"code": "363L00000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner",
"state": "SC",
"license": "3688",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "GP2128",
"state": "SC"
}
],
"endpoints": [
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "ccanaday3984@direct.musc.edu",
"affiliation": "N",
"use": "DIRECT",
"useDescription": "Direct",
"address_1": "Musc Hollings Cancer Ctr",
"address_2": "86 Jonathan Lucas St.",
"city": "Charleston",
"state": "SC",
"country_code": "US",
"postal_code": "294250001",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}
Other providers in Charleston, SC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 4, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.