Individual provider Active NPI

James Michael Conerly, MD

  • Surgery Physician
  • Alexandria, LA
National Provider Identifier
1528067873
Registry record updated Sep 29, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
License
08316R Issued in LA
Practice address
3311 Prescott Rd
Suite 201
Alexandria, LA 71301-3900
Phone
(318) 442-6767
Fax
(318) 441-1359
NPI assigned
Jul 19, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 29, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X 08316R LA Primary

Addresses

Primary practice location

3311 Prescott Rd
Suite 201
Alexandria, LA 71301-3900

Mailing address

3311 Prescott Rd
Suite 201
Alexandria, LA 71301-3900
Phone (318) 442-6767

Other identifiers 6

IdentifierTypeStateIssuer
331030935COOtherOCHSNER
331030935A004OtherTRICARE
5N052CD82OtherALL
020054415OtherALL
1903167OtherBLUE CROSS
1903167MedicaidLA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in LA
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
I20060407000568 LA Practitioner - General Surgery 4880600030 Reassigns benefits to 1 organization

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Christus Health Central Louisiana CurrentSince Jun 1, 2016 Accepting new patients
Christus Health Central Louisiana CurrentSince Apr 30, 2003 Accepting new patients

Locations

3330 Masonic Dr
Alexandria, LA 71301
Phone (318) 448-6917

3311 Prescott Rd
Ste 200
Alexandria, LA 71301
Phone (318) 442-0106

3311 Prescott Rd
Ste 201
Alexandria, LA 71301
Phone (318) 442-6767

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1121731200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1317254400000",
    "number": "1528067873",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3311 PRESCOTT RD",
            "address_2": "SUITE 201",
            "city": "ALEXANDRIA",
            "state": "LA",
            "postal_code": "713013900",
            "telephone_number": "318-442-6767",
            "fax_number": "318-441-1359"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3311 PRESCOTT RD",
            "address_2": "SUITE 201",
            "city": "ALEXANDRIA",
            "state": "LA",
            "postal_code": "713013900",
            "telephone_number": "318-442-6767",
            "fax_number": "318-441-1359"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CONERLY",
        "first_name": "JAMES",
        "middle_name": "MICHAEL",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-07-19",
        "last_updated": "2011-09-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "LA",
            "license": "08316R",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OCHSNER",
            "identifier": "331030935CO",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TRICARE",
            "identifier": "331030935A004",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ALL",
            "identifier": "5N052CD82",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ALL",
            "identifier": "020054415",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS",
            "identifier": "1903167",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1903167",
            "state": "LA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Alexandria, LA

Sources for this page

Verify at the official NPI Registry.