Individual provider Active NPI

William R Conyer, MD

  • Family Medicine Physician
  • Paducah, KY
National Provider Identifier
1366409088
Registry record updated Feb 28, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
21496 Issued in KY
Practice address
5158 Village Square Dr
Paducah, KY 42001-9060
Phone
(270) 443-4311
Fax
(270) 443-4145
NPI assigned
Apr 27, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 28, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 21496 KY Primary

Addresses

Primary practice location

5158 Village Square Dr
Paducah, KY 42001-9060

Mailing address

5158 Village Square Dr
Paducah, KY 42001-9060
Phone (270) 443-4311

Other identifiers 1

IdentifierTypeStateIssuer
64214968MedicaidKY

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KY
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
I20100121000362 KY Practitioner - Family Practice 0042352510 Reassigns benefits to 1 organization

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Baptist Health Medical Group Inc Family Medicine CurrentSince Jan 4, 2015 Accepting new patients
Western Baptist Medical Ventures, Inc. Past Accepting new patients

Locations

3900 Kresge Way
Ste 41
Louisville, KY 40207
Phone (502) 896-1313

2603 Kentucky Ave
Ste 304
Paducah, KY 42003
Phone (270) 415-4800

2601 Kentucky Ave
Ste 103
Paducah, KY 42003
Phone (270) 415-4860

2603 Kentucky Ave
Ste 404
Paducah, KY 42003
Phone (270) 443-6472

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": "1146096000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1204156800000",
    "number": "1366409088",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5158 VILLAGE SQUARE DR",
            "city": "PADUCAH",
            "state": "KY",
            "postal_code": "420019060",
            "telephone_number": "270-443-4311",
            "fax_number": "270-443-4145"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5158 VILLAGE SQUARE DR",
            "city": "PADUCAH",
            "state": "KY",
            "postal_code": "420019060",
            "telephone_number": "270-443-4311",
            "fax_number": "270-443-4145"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CONYER",
        "first_name": "WILLIAM",
        "middle_name": "R",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-04-27",
        "last_updated": "2008-02-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "KY",
            "license": "21496",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "64214968",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Paducah, KY

Sources for this page

Verify at the official NPI Registry.