John Ellis Conley II, M.D.

Primary specialty

Psychiatry PhysicianTaxonomy code 2084P0800X

License

55683 Issued in FL

Practice address

2152 Gold Dust CT
Trinity, FL 34655-5015

Phone

(727) 375-8619

NPI assigned

Mar 20, 2007

Last updated

Nov 2, 2009By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 4

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

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.

• Magellan Health Services of Arizona, Inc

  • Case Management Agency
  • Gilbert, AZ
  • NPI 1194965145
  NPD (past)
• Vo of Arizona, Inc.

  dba ValueOptions Laboratory Services

  • Clinical Medical Laboratory
  • Glendale, AZ
  • NPI 1447458682
  NPD (past)

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

{
    "created_epoch": "1174348800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1257120000000",
    "number": "1063537249",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2152 GOLD DUST CT",
            "city": "TRINITY",
            "state": "FL",
            "postal_code": "346555015",
            "telephone_number": "727-375-8619"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2152 GOLD DUST CT",
            "city": "TRINITY",
            "state": "FL",
            "postal_code": "346555015",
            "telephone_number": "727-375-8619"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CONLEY",
        "first_name": "JOHN",
        "middle_name": "ELLIS",
        "name_prefix": "Dr.",
        "name_suffix": "II",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-03-20",
        "last_updated": "2009-11-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "AZ",
            "license": "23641",
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "FL",
            "license": "55683",
            "primary": true
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "HI",
            "license": "MD6535",
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "VA",
            "license": "0101241572",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "FL MEDICARE B PROVIDER NUMBER",
            "identifier": "11388A",
            "state": "FL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "270964300",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• James F Coleman, APRN
• Amanda Colucci, DPT
• Michele Comiskey, APRN
• Iris Norma Concepcion, ARNP
• Conforti's Crossroads Chiropractic Inc.
• Suzanne Marie Conrad, ED.S.
• Danielle Cuglietta Cook, BCBA
• Jennifer Lynne Cook, MD
• William Arthur Cooper, D.O.
• Karen Corning, D.O.

• Psychiatry Physician in Trinity, FL
• Providers in Trinity, FL by specialty
• Psychiatry Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 2, 2009; 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.