Individual provider Active NPI

John David Conley, D.O.

  • Family Medicine Physician
  • Durant, OK
National Provider Identifier
1659438034
Registry record updated Sep 20, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
4448 Issued in OK
Practice address
1327 N 16TH Ave
Durant, OK 74701-2134
Phone
(580) 745-1011
Fax
(580) 745-5332
NPI assigned
Jan 3, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 20, 2022

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 4448 OK Primary

Addresses

Primary practice location

1327 N 16TH Ave
Durant, OK 74701-2134

Mailing address

PO Box 960251
Oklahoma City, OK 73196-0001
Phone (580) 548-1367

Other identifiers 1

IdentifierTypeStateIssuer
200113430AMedicaidOK

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OK
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
I20070830000172 OK Practitioner - Family Practice 4183717564 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 2005
Medicare assignment
May accept Medicare assignment
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

1323 N 16TH Ave
Durant, OK 74701-2134
Phone (580) 745-1011

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
4448OKMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Marshall County Hma LLC Family Medicine Past Accepting new patients
Marshall County Hma, LLC Past Accepting new patients
Marshall County Hma LLC Family Medicine Past Accepting new patients

Organizations & group practices 4

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.

Hospital & facility affiliations 5

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1167782400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1663632000000",
    "number": "1659438034",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 960251",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "731960001",
            "telephone_number": "580-548-1367",
            "fax_number": "580-548-1583"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1327 N 16TH AVE",
            "city": "DURANT",
            "state": "OK",
            "postal_code": "747012134",
            "telephone_number": "580-745-1011",
            "fax_number": "580-745-5332"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CONLEY",
        "first_name": "JOHN",
        "middle_name": "DAVID",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-01-03",
        "last_updated": "2022-09-20",
        "certification_date": "2022-09-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "OK",
            "license": "4448",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200113430A",
            "state": "OK"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Durant, OK

Sources for this page

Verify at the official NPI Registry.