Individual provider Active NPI

Malcolm L. Conway

  • Chiropractor
  • Wyoming, PA
National Provider Identifier
1215043617
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
DC002774L Issued in PA
Practice address
1150 Wyoming Ave
Suite 500
Wyoming, PA 18644-1366
Phone
(570) 287-7070
Fax
(570) 287-5575
NPI assigned
Aug 21, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X DC002774L PA Primary

Addresses

Primary practice location

1150 Wyoming Ave
Suite 500
Wyoming, PA 18644-1366

Mailing address

1150 Wyoming Ave
Suite 500
Wyoming, PA 18644-1366
Phone (570) 287-7070

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050811000685 PA Practitioner - Chiropractic 1254360050 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Sherman College of Straight Chiropractic, 1984
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Conway Chiropractic PCGroup PAC ID 3476530205, 2 clinicians

Practice addresses (Care Compare)

540 Pierce St
Kingston, PA 18704-5760
Phone (570) 287-7070

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
DC002774LPAMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Conway Chiropractic PC Chiropractor CurrentSince Jun 21, 1984 Accepting new patients

Locations

540 Pierce St
Kingston, PA 18704
Phone (570) 287-2700

575 Pierce St
Ste 102
Kingston, PA 18704
Phone (570) 287-7070

1150 Wyoming Ave
Ste 500
Wyoming, PA 18644
Phone (570) 287-7070

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.

NPI Registry JSON

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

{
    "created_epoch": "1156118400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1215043617",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1150 WYOMING AVE",
            "address_2": "SUITE 500",
            "city": "WYOMING",
            "state": "PA",
            "postal_code": "186441366",
            "telephone_number": "570-287-7070",
            "fax_number": "570-287-5575"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1150 WYOMING AVE",
            "address_2": "SUITE 500",
            "city": "WYOMING",
            "state": "PA",
            "postal_code": "186441366",
            "telephone_number": "570-287-7070",
            "fax_number": "570-287-5575"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CONWAY",
        "first_name": "MALCOLM",
        "middle_name": "L.",
        "name_prefix": "Dr.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-08-21",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "PA",
            "license": "DC002774L",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wyoming, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • 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.