Individual provider Active NPI

Pamela M Conry, CNS

  • Neonatal Clinical Nurse Specialist
  • Rio Rancho, NM
National Provider Identifier
1063540797
Registry record updated Aug 14, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neonatal Clinical Nurse SpecialistTaxonomy code 364SN0000X
License
R50417 Issued in NM
Practice address
PMG High Resort 4005
4005 High Resort Blvd
Rio Rancho, NM 87124
Phone
(505) 462-6000
Fax
(505) 462-8470
NPI assigned
Mar 2, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 14, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Neonatal Clinical Nurse Specialist 364SN0000X R50417 NM Primary

Addresses

Primary practice location

PMG High Resort 4005
4005 High Resort Blvd
Rio Rancho, NM 87124

Mailing address

PO Box 26666
PHS Provider Enrollment
Albuquerque, NM 87125-6666
Phone (505) 923-5356

Other identifiers 1

IdentifierTypeStateIssuer
72638583MedicaidNM

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
Certified Nurse Specialist

NPI Registry JSON

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

{
    "created_epoch": "1172793600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1218672000000",
    "number": "1063540797",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 26666",
            "address_2": "PHS PROVIDER ENROLLMENT",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871256666",
            "telephone_number": "505-923-5356",
            "fax_number": "505-923-5354"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "PMG HIGH RESORT 4005",
            "address_2": "4005 HIGH RESORT BLVD",
            "city": "RIO RANCHO",
            "state": "NM",
            "postal_code": "87124",
            "telephone_number": "505-462-6000",
            "fax_number": "505-462-8470"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CONRY",
        "first_name": "PAMELA",
        "middle_name": "M",
        "credential": "CNS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-03-02",
        "last_updated": "2008-08-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "364SN0000X",
            "taxonomy_group": "",
            "desc": "Clinical Nurse Specialist, Neonatal",
            "state": "NM",
            "license": "R50417",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "72638583",
            "state": "NM"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Rio Rancho, NM

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 14, 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.