Mary Jordan Conzelman

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

1-181941 Issued in AL

Practice address

2700 Highway 280 S Ste 212
Mountain BRK, AL 35223-2468

Phone

(205) 878-4368

NPI assigned

Sep 26, 2022

Last updated

Oct 19, 2024By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other names 1

• Mary Elizabeth Jordan Former name

Medicare fee-for-service enrollment

Enrolled in AL

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

Specialty

Pain Management

Education

Other, 2024

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Comprehensive Pain Center, PCGroup PAC ID 9830524594, 13 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://api.platform.athenahealth.com/20537/brand/1/csg/1/fhir/r4

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.

• Comprehensive Pain Center, PC

  • Pain Medicine (Anesthesiology) Physician
  • Mountain BRK, AL
  • NPI 1871137943
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1664150400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1729296000000",
    "number": "1316660210",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3345 MOUNTAINSIDE RD",
            "city": "VESTAVIA",
            "state": "AL",
            "postal_code": "352435012",
            "telephone_number": "251-508-7571"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2700 HIGHWAY 280 S STE 212",
            "city": "MOUNTAIN BRK",
            "state": "AL",
            "postal_code": "352232468",
            "telephone_number": "205-878-4368"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CONZELMAN",
        "first_name": "MARY",
        "middle_name": "JORDAN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-09-26",
        "last_updated": "2024-10-19",
        "certification_date": "2024-10-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "AL",
            "license": "1-181941",
            "primary": true
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "AL",
            "license": "1-181941",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MARY",
            "last_name": "JORDAN",
            "middle_name": "ELIZABETH",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Haleigh Nicole Collins, MS, CF-SLP
• Combs Village Healthcare (Village Healthcare)
• Bryan Patrick Combs, PHD, CRNP, FNP-S
• Comprehensive Pain Center, PC
• Connect Counseling & Consulting LLC
• Carlton Cooper, AMFT
• Copeland Counseling & Consulting
• Rachel Copeland, LCSW, PHD
• Tracy Copeland, MS,MED/CCC-SLP
• Bethany Corey, RD, LD

• Family Nurse Practitioner in Mountain BRK, AL
• Providers in Mountain BRK, AL by specialty
• Family Nurse Practitioner in Alabama

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 19, 2024; 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.