Kelly L Conley, RN

Primary specialty

Psychiatric/Mental Health Registered NurseTaxonomy code 163WP0808X

License

RN.417169 Issued in OH

Practice address

4384 Rhodes Ave
New Boston, OH 45662-5533

Phone

(740) 566-5600

NPI assigned

Feb 25, 2016

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Registered Nurse

State licenses

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://api.qualifacts.org/api/fhir/pathihc/r4/

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Phoenix Group Home, LLC

  dba PATH Integrated Healthcare

  • Community/Behavioral Health Agency
  • Portsmouth, OH
  • NPI 1083146013
  NPD
• Phoenix Group Home, LLC

  dba Path Behavioral Health- SUD

  • Substance Abuse Rehabilitation Facility
  • Cincinnati, OH
  • NPI 1336654854
  NPD (past)

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

{
    "created_epoch": "1456358400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1679270400000",
    "number": "1174983787",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5439 BURKHARDT RD",
            "city": "DAYTON",
            "state": "OH",
            "postal_code": "454312111",
            "telephone_number": "740-352-7289"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4384 RHODES AVE",
            "city": "NEW BOSTON",
            "state": "OH",
            "postal_code": "456625533",
            "telephone_number": "740-566-5600"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "46 Andrea Dr",
            "address_purpose": "LOCATION",
            "city": "Wheelersburg",
            "state": "OH",
            "postal_code": "456948789",
            "country_code": "US",
            "telephone_number": "740-357-7315",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CONLEY",
        "first_name": "KELLY",
        "middle_name": "L",
        "credential": "RN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-02-25",
        "last_updated": "2023-03-20",
        "certification_date": "2023-03-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "OH",
            "license": "RN417169",
            "primary": false
        },
        {
            "code": "163WP0808X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Psychiatric/Mental Health",
            "state": "OH",
            "license": "RN.417169",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ashlee Nicole Clay
• Mary Clifford
• Karsyn Gabrielle Conaway
• Amy Lee Conkel, OTR/L
• Timothy P Conkel II
• Jodi L Cooper
• Lori Elizabeth Cooper, RN, BSN
• Michelle Cremeans, LPN
• Jordan Darlene Dailey, COTA/L
• David and Brenda Catering (Village Catering)

• Psychiatric/Mental Health Registered Nurse in New Boston, OH
• Providers in New Boston, OH by specialty
• Psychiatric/Mental Health Registered Nurse in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 20, 2023; 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.