Individual provider Active NPI

John Michael Conoyer, M.D.

  • Otolaryngology Physician
  • Saint Peters, MO
National Provider Identifier
1295750586
Registry record updated Apr 11, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Otolaryngology PhysicianTaxonomy code 207Y00000X
License
MOR6833 Issued in MO
Practice address
4790 Executive Centre Pkwy
Saint Peters, MO 63376-1606
Phone
(636) 441-3100
Fax
(636) 441-6784
NPI assigned
Jul 13, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 11, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Otolaryngology Physician 207Y00000X MOR6833 MO Primary

Addresses

Primary practice location

4790 Executive Centre Pkwy
Saint Peters, MO 63376-1606

Mailing address

4790 Executive Centre Pkwy
Saint Peters, MO 63376-1606
Phone (636) 441-3100

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MO
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 1

Enrollment IDStateProvider typePAC IDDetails
I20110323000547 MO Practitioner - OtolaryngologyPractitioner - Allergy/Immunology 6507968302 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
MOR6833MOMDOtolaryngology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Novamed Surgery Center of St Peters LLC PastSince Jan 1, 2007 Accepting new patients

Interoperability endpoints

  • Direct secure messaging: jmichaelconoyer@mentc.allscriptsdirect.net
  • Direct secure messaging: mconoyer134554@direct.carenet.org

Organizations & group practices 2

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": "1152748800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1334102400000",
    "number": "1295750586",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4790 EXECUTIVE CENTRE PKWY",
            "city": "SAINT PETERS",
            "state": "MO",
            "postal_code": "633761606",
            "telephone_number": "636-441-3100",
            "fax_number": "636-441-6784"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4790 EXECUTIVE CENTRE PKWY",
            "city": "SAINT PETERS",
            "state": "MO",
            "postal_code": "633761606",
            "telephone_number": "636-441-3100",
            "fax_number": "636-441-6784"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CONOYER",
        "first_name": "JOHN",
        "middle_name": "MICHAEL",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-13",
        "last_updated": "2012-04-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Y00000X",
            "taxonomy_group": "",
            "desc": "Otolaryngology",
            "state": "MO",
            "license": "MOR6833",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Saint Peters, MO

Sources for this page

Verify at the official NPI Registry.