Individual provider Active NPI

Elizabeth Anne Conway, NP

  • Nurse Practitioner
  • Ann Arbor, MI
National Provider Identifier
1639577877
Registry record updated Feb 2, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
4704269128 Issued in MI
Practice address
4260 Plymouth Rd
Ann Arbor, MI 48109-2700
Phone
(734) 764-6831
NPI assigned
Dec 19, 2014
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 2, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 4704269128 MI Primary

Addresses

Primary practice location

4260 Plymouth Rd
Ann Arbor, MI 48109-2700

Mailing address

3621 S State St
Ann Arbor, MI 48108-1633
Phone (734) 647-5299

Other practice location 1

2850 S Industrial Hwy Ste 50
Ann Arbor, MI 48104-6792
Phone (734) 477-7228

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20150508000684 MI Practitioner - Nurse Practitioner 0648593335 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

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.

NPI Registry JSON

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

{
    "created_epoch": "1418947200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1675296000000",
    "number": "1639577877",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3621 S STATE ST",
            "city": "ANN ARBOR",
            "state": "MI",
            "postal_code": "481081633",
            "telephone_number": "734-647-5299"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4260 PLYMOUTH RD",
            "city": "ANN ARBOR",
            "state": "MI",
            "postal_code": "481092700",
            "telephone_number": "734-764-6831"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2850 S Industrial Hwy Ste 50",
            "address_purpose": "LOCATION",
            "city": "Ann Arbor",
            "state": "MI",
            "postal_code": "481046792",
            "country_code": "US",
            "telephone_number": "734-477-7228",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CONWAY",
        "first_name": "ELIZABETH",
        "middle_name": "ANNE",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-12-19",
        "last_updated": "2023-02-02",
        "certification_date": "2023-02-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "MI",
            "license": "4704269128",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ann Arbor, MI

Sources for this page

Verify at the official NPI Registry.