NPIMap

Organization Active NPI

Conroe Willis Family Medicine, PLLC

  • Family Medicine Physician
  • Conroe, TX
National Provider Identifier
1508249798
Registry record updated Apr 4, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
CONROE WILLIS FAMILY MEDICINE, PLLC
Practice address
4015 I 45 N Ste 220
Conroe, TX 77304-5076
Phone
(936) 441-1122
Fax
(936) 788-9151
NPI assigned
Jul 7, 2015
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 4, 2023

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

Authorized official

Name
Dr. Robert Jeremy Laningham, M.D.NPI 1700973682
Title
Physician/ Co-Owner
Phone
(936) 441-1122

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207Q00000X Primary

Addresses

Primary practice location

4015 I 45 N Ste 220
Conroe, TX 77304-5076

Mailing address

4015 I 45 N Ste 220
Conroe, TX 77304-5076
Phone (936) 441-1122

Other practice location 1

9851 Fm 1097 Rd W Ste 120
Willis, TX 77318-5852
Phone (936) 890-8000

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20151231000117 TX Part B Supplier - Clinic/Group Practice 9931401320 Receives reassigned benefits from 6 practitioners
Practice locations: Conroe, TX; Willis, TX

National Provider Directory

National Provider Directory

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/30698/brand/1/csg/1/fhir/r4

Practitioners & affiliated clinicians

Practitioners 8

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1436227200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1680566400000",
    "number": "1508249798",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4015 I 45 N STE 220",
            "city": "CONROE",
            "state": "TX",
            "postal_code": "773045076",
            "telephone_number": "936-441-1122",
            "fax_number": "936-788-9151"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4015 I 45 N STE 220",
            "city": "CONROE",
            "state": "TX",
            "postal_code": "773045076",
            "telephone_number": "936-441-1122",
            "fax_number": "936-788-9151"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "9851 Fm 1097 Rd W Ste 120",
            "address_purpose": "LOCATION",
            "city": "Willis",
            "state": "TX",
            "postal_code": "773185852",
            "country_code": "US",
            "telephone_number": "936-890-8000",
            "fax_number": "936-890-9000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "CONROE WILLIS FAMILY MEDICINE, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-07-07",
        "last_updated": "2023-04-04",
        "certification_date": "2021-04-07",
        "status": "A",
        "authorized_official_last_name": "LANINGHAM",
        "authorized_official_first_name": "ROBERT",
        "authorized_official_middle_name": "JEREMY",
        "authorized_official_title_or_position": "PHYSICIAN/ CO-OWNER",
        "authorized_official_telephone_number": "936-441-1122",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Conroe, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 4, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.