NPIMap

Individual provider Active NPI

Staci Faulkner Condrey, MD

  • Internal Medicine Physician
  • Concord, NC
National Provider Identifier
1922078831
Registry record updated Jul 15, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
9900192 Issued in NC
Practice address
3020 Weddington Rd
Concord, NC 28027-8158
Phone
(704) 403-7700
NPI assigned
Jan 24, 2006
Last updated
Jul 15, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 15, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 9900192 NC
Internal Medicine Physician 207R00000X 9900192 NC Primary

Addresses

Primary practice location

3020 Weddington Rd
Concord, NC 28027-8158

Mailing address

PO Box 19305
Charlotte, NC 28219-9305

Other practice location 1

201 Dale Earnhardt Blvd
Ste 200
Kannapolis, NC 28081-0308
Phone (704) 932-1155

Electronic endpoints 2

TypeEndpointUseAffiliation
CONNECT URL https://esmd.abilitynetwork.com:8291/Gateway/DocumentSubmission/2_0/NhinService/XDRRequest_Service Other ABILITY Network
Direct Messaging Address scondrey128874@CarolinasHealthcareSystem.direct-ci.com Atrium Health

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20070710000913 NC Practitioner - Internal MedicinePractitioner - Pediatric Medicine 2365542057 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal MedicineAlso: Pediatric Medicine
Education
Brody School of Medicine at East Carolina University, 1995
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Carolinas Physicians Network IncGroup PAC ID 3375449655, 2,324 clinicians

Practice addresses (Care Compare)

3020 Weddington Rd
Concord, NC 28027-8158
Phone (704) 403-7700

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
94 of 100Reported as apm
Quality
81.63
Promoting interoperability
100
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
9900192NCMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Carolinas Physicians Network Inc Internal Medicine CurrentSince Jul 31, 2023 Accepting new patients
Carolinas Physicians Network Inc CurrentSince Jul 31, 2023 Accepting new patients
Carolinas Physicians Network Inc Current Accepting new patients
The Charlotte-Mecklenburg Hospital Authority Internal Medicine Current Accepting new patients
The Charlotte-Mecklenburg Hospital Authority Internal Medicine CurrentSince Dec 1, 2013 Accepting new patients
The Charlotte-Mecklenburg Hospital Authority CurrentSince Dec 1, 2013 Accepting new patients
The Charlotte-Mecklenburg Hospital Authority Internal Medicine Past Accepting new patients

Locations

100 N 6th St
Ste 900A
Minneapolis, MN 55403

14214 Ballantyne Lake Rd
Ste 100
Charlotte, NC 28277
Phone (704) 667-2650

14214 Ballantyne Lake Rd
Ste 300
Charlotte, NC 28277
Phone (704) 446-5070

1085 NE Gateway Ct NE
#200A
Concord, NC 28025
Phone (704) 403-8650

200 Medical Park Dr
Ste 250
Concord, NC 28025
Phone (704) 403-2740

3020 Weddington Rd
Concord, NC 28027
Phone (704) 403-7700

920 Church St N
Concord, NC 28025
Phone (704) 403-3000

201 Dale Earnhardt Blvd
Ste 200
Kannapolis, NC 28081
Phone (704) 403-7300

8560 Cook St
Mt Pleasant, NC 28124
Phone (704) 403-1911

Interoperability endpoints

  • Direct secure messaging: scondrey128874@carolinashealthcaresystem.direct-ci.com

Organizations & group practices 7

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.

Hospital & facility affiliations 8

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1138060800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1721001600000",
    "number": "1922078831",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 19305",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282199305"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3020 WEDDINGTON RD",
            "city": "CONCORD",
            "state": "NC",
            "postal_code": "280278158",
            "telephone_number": "704-403-7700"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "201 Dale Earnhardt Blvd",
            "address_2": "Ste 200",
            "address_purpose": "LOCATION",
            "city": "Kannapolis",
            "state": "NC",
            "postal_code": "280810308",
            "country_code": "US",
            "telephone_number": "704-932-1155",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CONDREY",
        "first_name": "STACI",
        "middle_name": "FAULKNER",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-01-24",
        "last_updated": "2024-07-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "NC",
            "license": "9900192",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NC",
            "license": "9900192",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "https://esmd.abilitynetwork.com:8291/Gateway/DocumentSubmission/2_0/NhinService/XDRRequest_Service",
            "affiliation": "Y",
            "endpointDescription": "2.16.840.1.113883.3.667.2",
            "affiliationName": "ABILITY Network",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "CMS esMD eMDR",
            "address_1": "100 N 6th St Ste 900A",
            "city": "Minneapolis",
            "state": "MN",
            "country_code": "US",
            "postal_code": "554031516",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "scondrey128874@CarolinasHealthcareSystem.direct-ci.com",
            "affiliation": "Y",
            "affiliationName": "Atrium Health",
            "address_1": "3020 Weddington Rd",
            "city": "Concord",
            "state": "NC",
            "country_code": "US",
            "postal_code": "280278158",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Concord, NC

Sources for this page

Verify at the official NPI Registry.