Active NPI
Mary Alyse Conley, LMT
- Specialist
- Medford, OR
National Provider Identifier
1194080069
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Specialist
- License
- 18674
- Practice address
- 107 E Main St Ste 30
Medford, OR 97501-6022 - Phone
- (541) 973-1137
- NPI assigned
- Jul 6, 2012
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Specialist | 174400000X | 18674 | OR | Primary |
Addresses
Primary practice location
107 E Main St Ste 30
Medford, OR 97501-6022
Mailing address
107 E Main St Ste 30
Medford, OR 97501-6022
Phone (541) 973-1137
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)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 18674 | OR | MD | Specialist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Nautilus Massage Therapy by Alyse Conley | Past | Accepting new patients |
Organizations & group practices 1
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.
-
- Point of Service
- Medford, OR
- NPI 1932580255
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1341532800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1683504000000",
"number": "1194080069",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "107 E MAIN ST STE 30",
"city": "MEDFORD",
"state": "OR",
"postal_code": "975016022",
"telephone_number": "541-973-1137"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "107 E MAIN ST STE 30",
"city": "MEDFORD",
"state": "OR",
"postal_code": "975016022",
"telephone_number": "541-973-1137"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CONLEY",
"first_name": "MARY",
"middle_name": "ALYSE",
"name_prefix": "Ms.",
"credential": "LMT",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2012-07-06",
"last_updated": "2023-05-08",
"certification_date": "2023-05-08",
"status": "A"
},
"taxonomies": [
{
"code": "174400000X",
"taxonomy_group": "",
"desc": "Specialist",
"state": "OR",
"license": "18674",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Medford, OR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 8, 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.