Individual provider Active NPI

George Ross McConnell, CSAC

  • Addiction (Substance Use Disorder) Counselor
  • Monroe, NC
National Provider Identifier
1851573745
Registry record updated Feb 1, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X
License
2141 Issued in NC
Practice address
1190 W Roosevelt Blvd
Monroe, NC 28110-2818
Phone
(704) 296-6200
NPI assigned
Dec 3, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 1, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) Counselor 101YA0400X 2141 NC Primary

Addresses

Primary practice location

1190 W Roosevelt Blvd
Monroe, NC 28110-2818

Mailing address

1305 S Cannon Blvd
Kannapolis, NC 28083-6232

Other identifiers 1

IdentifierTypeStateIssuer
147V2OtherNCBCBS

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)
Not enrolled

State licenses

LicenseStateTypeSpecialty
2141NCMDAddiction (Substance Use Disorder) Counselor

NPI Registry JSON

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

{
    "created_epoch": "1196640000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1201824000000",
    "number": "1851573745",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1305 S CANNON BLVD",
            "city": "KANNAPOLIS",
            "state": "NC",
            "postal_code": "280836232"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1190 W ROOSEVELT BLVD",
            "city": "MONROE",
            "state": "NC",
            "postal_code": "281102818",
            "telephone_number": "704-296-6200"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCCONNELL",
        "first_name": "GEORGE",
        "middle_name": "ROSS",
        "credential": "CSAC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-12-03",
        "last_updated": "2008-02-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "NC",
            "license": "2141",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "147V2",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Monroe, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 1, 2008; 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.