Individual provider Active NPI

Susan Conway, M.D.

  • Specialist
  • Lafayette, LA
National Provider Identifier
1245201334
Registry record updated Dec 14, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
54192 Issued in GA
Practice address
206 E Farrel Rd Ste 270
Lafayette, LA 70508-7104
Phone
(337) 989-8795
Fax
(404) 843-0812
NPI assigned
Jan 28, 2006
Sex
Female
Sole proprietor
No

Organizations & group practices 3

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.

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
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
54192GAMDSpecialist

Practice roles

OrganizationSpecialtyStatusNew patients
Georgia Reproductive Spec 2 LLC Past Accepting new patients
Georgia Reproductive Specialists, LLC Specialist PastSince Sep 1, 2023 Accepting new patients
Center for Reproductive Medicine of New Mexico Past Accepting new patients

Specialties & licenses 1

NPPES NPI Registry
Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X 54192 GA Primary

Addresses

NPPES NPI Registry

Primary practice location

206 E Farrel Rd Ste 270
Lafayette, LA 70508-7104

Mailing address

5445 Meridian Marks Rd NE
Suite 270
Atlanta, GA 30342-4763
Phone (404) 843-2229

Other identifiers 1

NPPES NPI Registry
IdentifierTypeStateIssuer
54192OtherGAGA STATE LICENSE

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Dec 14, 2020.

{
    "created_epoch": "1138406400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1607904000000",
    "number": "1245201334",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5445 MERIDIAN MARKS RD NE",
            "address_2": "SUITE 270",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303424763",
            "telephone_number": "404-843-2229",
            "fax_number": "404-843-0812"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "206 E FARREL RD STE 270",
            "city": "LAFAYETTE",
            "state": "LA",
            "postal_code": "705087104",
            "telephone_number": "337-989-8795",
            "fax_number": "404-843-0812"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CONWAY",
        "first_name": "SUSAN",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-01-28",
        "last_updated": "2020-12-14",
        "certification_date": "2020-12-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "GA",
            "license": "54192",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GA STATE LICENSE",
            "identifier": "54192",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Lafayette, LA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 14, 2020; 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.