Jill K. Conway, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

PA04440 Issued in TX

Practice address

5939 Harry Hines Blvd
Suite 400, Mail Code 9191
Dallas, TX 75390-9191

Phone

(214) 645-2422

Fax

(214) 645-2420

NPI assigned

Mar 3, 2006

Last updated

Mar 4, 2011By the provider in NPPES

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

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in OR

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Physician Assistant

Education

Other, 2004

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Dermatology Health Specialists, PCGroup PAC ID 7214260603, 6 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: jill.conway.1@19536.direct.athenahealth.com

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

• Dermatology Health Specialists, PC

  • Dermatology Physician
  • Bend, OR
  • NPI 1447713573
  Medicare reassignment Care Compare group
• Blue Mountain Hospital District

  dba Strawberry Wilderness Community Clinic

  • Rural Health Clinic/Center
  • John Day, OR
  • NPI 1568536035
  Medicare reassignment
• Central Oregon Dermatology, PC

  • Clinic/Center
  • Bend, OR
  • NPI 1336307875
  Medicare reassignment
• Harney District Hospital

  • Critical Access Hospital
  • Burns, OR
  • NPI 1285742338
  Medicare reassignment
• Harney District Hospital

  dba NewSun Energy & Harney District Hospital Specialty Care

  • Multi-Specialty Clinic/Center
  • Burns, OR
  • NPI 1972113306
  NPD
• Dallas County Hospital District

  dba CV Roman Women's Health Center

  • Women's Health Nurse Practitioner
  • Dallas, TX
  • NPI 1558035188
  NPD (past)
• Vickery Health Center

  • Psychologist
  • Dallas, TX
  • NPI 1831166446
  NPD (past)

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

{
    "created_epoch": "1141344000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1299196800000",
    "number": "1255308656",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5939 HARRY HINES BLVD",
            "address_2": "SUITE 400, MAIL CODE 9191",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "753909191"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5939 HARRY HINES BLVD",
            "address_2": "SUITE 400, MAIL CODE 9191",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "753909191",
            "telephone_number": "214-645-2422",
            "fax_number": "214-645-2420"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CONWAY",
        "first_name": "JILL",
        "middle_name": "K.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-03-03",
        "last_updated": "2011-03-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "TX",
            "license": "PA04440",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "180843801",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "8N9852",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Luis Contreras, PHARMD
• Maurica Ann Contreras, ANP CNS
• Converging Health LLC
• Allison Conway, MA, LPC
• Brian Conway, MD, MS
• Jesse Marie Conyers, M.D.
• Suzanne D Conzen, MD
• Kathy Adrianne Cook Porter, NP
• Allyson Claire Cook
• Annabelle Rose Cook

• Physician Assistant in Dallas, TX
• Providers in Dallas, TX by specialty
• Physician Assistant in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 4, 2011; 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.