Georgia Edmondson Conic, PH.D.

Primary specialty

PsychologistTaxonomy code 103T00000X

License

6301007381 Issued in MI

Practice address

100 S Jefferson Ave
Suite 202
Saginaw, MI 48607-1267

Phone

(989) 752-6628

Fax

(989) 752-0895

NPI assigned

Oct 12, 2007

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

HHS exclusion list flag

Flagged The directory lists this NPI on an HHS exclusion list. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.

Credentials

Doctor of Philosophy

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

{
    "created_epoch": "1192147200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1372204800000",
    "number": "1073701280",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 S JEFFERSON AVE",
            "address_2": "SUITE 202",
            "city": "SAGINAW",
            "state": "MI",
            "postal_code": "486071267",
            "telephone_number": "989-752-6628",
            "fax_number": "989-752-0895"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 S JEFFERSON AVE",
            "address_2": "SUITE 202",
            "city": "SAGINAW",
            "state": "MI",
            "postal_code": "486071267",
            "telephone_number": "989-752-6628",
            "fax_number": "989-752-0895"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CONIC",
        "first_name": "GEORGIA",
        "middle_name": "EDMONDSON",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-10-12",
        "last_updated": "2013-06-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "MI",
            "license": "6301007381",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 26, 2013; 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.