Mary Jordan Conzelman – Family Nurse Practitioner

Key facts

NPI: 1316660210
Entity type: Individual (NPI type 1)
Primary specialty: Family Nurse Practitioner 363LF0000X
License: 1-181941 (AL)
Practice address: 2700 Highway 280 S Ste 212
Mountain BRK, AL 35223-2468
Phone: (205) 878-4368
NPI assigned: Sep 26, 2022
Sex: Female
Sole proprietor: Yes

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.

Comprehensive Pain Center, PC Pain Medicine (Anesthesiology) Physician · Mountain BRK, AL · NPI 1871137943

Medicare reassignment Care Compare group NPD AL

Medicare Care Compare profile

Specialty: Pain Management
Education: Other, 2024
Medicare assignment: Accepts the Medicare-approved amount as payment in full
Group practices: Comprehensive Pain Center, PC (13 clinicians)

Practice addresses (Care Compare)

2700 Hwy 280 S
Suite 212
Birmingham, AL 35223-2468
Phone (205) 878-4368

Medicare participation

Medicare fee-for-service enrollment: Enrolled in AL
Eligible to order & refer: Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes

Medicare enrollment records

Enrollment ID	State	Provider type	PAC ID	Details
I20250211001921	AL	Practitioner - Pain Management	9830629542	Reassigns benefits to 1 organization

National Provider Directory

Medicare enrollment (NPD): Yes

Practice roles

Organization	Specialty	Status	New patients
Comprehensive Pain Center, PC		Current since Jan 1, 2025	Accepting new patients

Locations

2700 Highway 280 S
Ste 212
Mountain Brk, AL 35223
Phone (205) 878-4368

Interoperability endpoints

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

Specialties & licenses

Specialty (taxonomy)	Code	License	State	Primary
Family Nurse Practitioner	363LF0000X	1-181941	AL	Yes
Registered Nurse	163W00000X	1-181941	AL

Addresses

Primary practice location

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

Mailing address

3345 Mountainside Rd
Vestavia, AL 35243-5012
Phone (251) 508-7571

Other names

Mary Elizabeth Jordan Former name

Other providers in Mountain BRK, AL

All providers in Mountain BRK, AL · Family Nurse Practitioner in Alabama

Sources for this page

NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Oct 19, 2024. Information in NPPES is self-reported and not verified by CMS.
NUCC Health Care Provider Taxonomy: specialty names.
Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
Order and Referring (CMS).
Medicare Care Compare provider data (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.