Jill Marie Conway, MD

Primary specialty

Neurology PhysicianTaxonomy code 2084N0400X

License

2008-01181 Issued in NC

Practice address

6324 Fairview Rd Ste 330
Charlotte, NC 28210-3260

Phone

(704) 316-2680

Fax

(704) 316-2681

NPI assigned

Dec 27, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in NC, VA2 enrollments

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 2

Specialty

Neurology

Education

University of Illinois College of Med (CHI/Peor/Rock/CHM-Urb), 2002

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Blacksburg Neurology PCGroup PAC ID 4183649825, 5 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: jconway779088@direct.novanthealth.org

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.

• Blacksburg Neurology PC

  • Specialist
  • Christiansburg, VA
  • NPI 1114937109
  Medicare reassignment Care Compare group NPD
• Carolinas Medical Center

  dba Atrium Health Levine Children's Gastroenterology

  • Obstetrics & Gynecology Physician
  • Charlotte, NC
  • NPI 1275774333
  Medicare reassignment NPD
• Carolinas Medical Center

  dba Atrium Health Colorectal Surgery

  • Internal Medicine Physician
  • Charlotte, NC
  • NPI 1932534914
  NPD
• Carolinas Medical Center

  dba Atrium Health Pharmacy Kenilworth

  • Community/Retail Pharmacy
  • Charlotte, NC
  • NPI 1982710554
  NPD
• Carolinas Pathology Group, PA

  dba Carolinas Pathology Group

  • Specialist
  • Charlotte, NC
  • NPI 1689628158
  NPD
• Executive Health Resources Clinical Staffing Solutions PC

  • Internal Medicine Physician
  • Newtown Square, PA
  • NPI 1225067424
  NPD (past)

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

{
    "created_epoch": "1167177600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1680220800000",
    "number": "1205991502",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 60447",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282600447",
            "telephone_number": "704-316-2680",
            "fax_number": "704-316-2681"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6324 FAIRVIEW RD STE 330",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282103260",
            "telephone_number": "704-316-2680",
            "fax_number": "704-316-2681"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1918 Randolph Rd Ste 400",
            "address_purpose": "LOCATION",
            "city": "Charlotte",
            "state": "NC",
            "postal_code": "282071196",
            "country_code": "US",
            "telephone_number": "704-384-9437",
            "fax_number": "704-384-9440",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1010 Edgehill Rd N",
            "address_purpose": "LOCATION",
            "city": "Charlotte",
            "state": "NC",
            "postal_code": "282071885",
            "country_code": "US",
            "telephone_number": "704-446-1900",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CONWAY",
        "first_name": "JILL",
        "middle_name": "MARIE",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-12-27",
        "last_updated": "2023-03-31",
        "certification_date": "2023-03-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084N0400X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "NC",
            "license": "2008-01181",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "jconway779088@direct.novanthealth.org",
            "affiliation": "N",
            "address_1": "1010 Edgehill Rd N",
            "city": "Charlotte",
            "state": "NC",
            "country_code": "US",
            "postal_code": "282071885",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Convergent Services Inc
• Converison Therapeutic Service
• Conversion Therapeutic Services Inc
• Conversion Therapeutic Services Inc
• Conversion Therapeutic Services Inc
• John Conway, MSW, LCSWA
• Mary Ellen Smith Conway, LCSW,LMFT,LCAS
• Cook and Associates of North Carolina PLLC
• Alexxis S Cook-Graham
• Andrew Bradley Cook, CRNA

• Neurology Physician in Charlotte, NC
• Providers in Charlotte, NC by specialty
• Neurology Physician in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 31, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• 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.