Individual provider Active NPI

Brian Conley, M.D.

  • Pediatrics Physician
  • Jefferson City, MO
National Provider Identifier
1093746653
Registry record updated Oct 18, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
R3G39 Issued in MO
Practice address
3348 American Ave
Jefferson City, MO 65109-1079
Phone
(573) 761-7210
Fax
(573) 634-5990
NPI assigned
Jul 5, 2006
Last updated
Oct 18, 2012By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 18, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X R3G39 MO Primary

Addresses

Primary practice location

3348 American Ave
Jefferson City, MO 65109-1079

Mailing address

3348 American Ave
Jefferson City, MO 65109-1079
Phone (573) 761-7210

Other identifiers 1

IdentifierTypeStateIssuer
202365201MedicaidMO

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
88.07 of 100Reported as group
Quality
86.39
Promoting interoperability
100
Improvement activities
40
Cost
73.83

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
R3G39MOMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Community Health Ctr of Central Missouri Past Accepting new patients
Community Health Ctr of Central Missouri Past Accepting new patients

Interoperability endpoints

  • Direct secure messaging: brian.conley.p1@direct.chccmo.nextgenshare.com

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1152057600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1350518400000",
    "number": "1093746653",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3348 AMERICAN AVE",
            "city": "JEFFERSON CITY",
            "state": "MO",
            "postal_code": "651091079",
            "telephone_number": "573-761-7210",
            "fax_number": "573-634-5990"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3348 AMERICAN AVE",
            "city": "JEFFERSON CITY",
            "state": "MO",
            "postal_code": "651091079",
            "telephone_number": "573-761-7210",
            "fax_number": "573-634-5990"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CONLEY",
        "first_name": "BRIAN",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-05",
        "last_updated": "2012-10-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "MO",
            "license": "R3G39",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "202365201",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Jefferson City, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 18, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.