Polly Kay Conley, R.N., P.N.P

Primary specialty

Pediatric Nurse PractitionerTaxonomy code 363LP0200X

License

14104 Issued in CA

Practice address

844 Old Tunnel Rd
Grass Valley, CA 95945

Phone

(530) 274-9762

Fax

(530) 273-0698

NPI assigned

Sep 12, 2012

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Nurse Practitioner, Registered Nurse

Practice roles

Interoperability endpoints

• Direct secure messaging: polly.conley@wsmc1.eclinicaldirectplus.com

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.

• Western Sierra Medical Clinic, Inc.

  • Federally Qualified Health Center (FQHC)
  • Grass Valley, CA
  • NPI 1063496396
  NPD (past)

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

{
    "created_epoch": "1347408000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1535500800000",
    "number": "1487904074",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10644 JAMES LN",
            "city": "NEVADA CITY",
            "state": "CA",
            "postal_code": "959593408",
            "telephone_number": "530-613-3116"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "844 OLD TUNNEL RD",
            "city": "GRASS VALLEY",
            "state": "CA",
            "postal_code": "95945",
            "telephone_number": "530-274-9762",
            "fax_number": "530-273-0698"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CONLEY",
        "first_name": "POLLY",
        "middle_name": "KAY",
        "name_prefix": "Ms.",
        "credential": "R.N., P.N.P",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-09-12",
        "last_updated": "2018-08-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "CA",
            "license": "14104",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Common Goals, Inc.
• Common Purpose
• Erin Compton
• Jeff Donovan Conklin
• Melanie Conley, DPT
• Tracey Renee Connell, PA
• Erin Connolly, MS
• Tomi M Connors Corbett, PT
• Julia Conrad, MFT 86901
• Meghan Heather Conroy

• Pediatric Nurse Practitioner in Grass Valley, CA
• Providers in Grass Valley, CA by specialty
• Pediatric Nurse Practitioner in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 29, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.