Individual provider Active NPI

Jessica Rose Conner

  • Family Nurse Practitioner
  • Thomasville, NC
National Provider Identifier
1992319115
Registry record updated Sep 4, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
5013511 Issued in NC
Practice address
201 W Holly Hill Rd
Thomasville, NC 27360-5738
Phone
(336) 475-9164
NPI assigned
Sep 4, 2020
Last updated
Sep 4, 2020By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 4, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 5013511 NC Primary

Addresses

Primary practice location

201 W Holly Hill Rd
Thomasville, NC 27360-5738

Mailing address

201 W Holly Hill Rd
Thomasville, NC 27360-5738

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20200921001626 NC Practitioner - Nurse Practitioner 1951729136 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

Medical Ctr Blvd
Winston Salem, NC 27157-0001
Phone (336) 716-2734

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
5013511NCMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Wake Forest University Health Sciences CurrentSince Apr 1, 2024 Accepting new patients
Wake Forest Health Network, LLC CurrentSince Oct 26, 2020 Accepting new patients
Wake Forest Health Network LLC CurrentSince Oct 26, 2020 Accepting new patients
Wake Forest Health Network LLC Current Accepting new patients

Locations

3150 N Elm St
Greensboro, NC 27408
Phone (336) 716-7811

905 Phillips Ave
High Point, NC 27262
Phone (336) 802-2040

201 W Holly Hill Rd
Thomasville, NC 27360
Phone (336) 475-9164

711 National Hwy
Ste 100
Thomasville, NC 27360
Phone (336) 475-2000

711 National Hwy
Ste 500
Thomasville, NC 27360
Phone (336) 474-1995

100 Kimel Forest Dr
Winston Salem, NC 27103
Phone (336) 713-0947

Medical Ctr Blvd
Winston Salem, NC 27157
Phone (336) 713-2697

Interoperability endpoints

  • Direct secure messaging: jconner2753477@carolinashealthcaresystem.direct-ci.com

Organizations & group practices 4

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": "1599177600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1599177600000",
    "number": "1992319115",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "201 W HOLLY HILL RD",
            "city": "THOMASVILLE",
            "state": "NC",
            "postal_code": "273605738"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "201 W HOLLY HILL RD",
            "city": "THOMASVILLE",
            "state": "NC",
            "postal_code": "273605738",
            "telephone_number": "336-475-9164"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CONNER",
        "first_name": "JESSICA",
        "middle_name": "ROSE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-09-04",
        "last_updated": "2020-09-04",
        "certification_date": "2020-09-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NC",
            "license": "5013511",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Thomasville, NC

Sources for this page

Verify at the official NPI Registry.