Kimberly Renee Conley, PA-C

Primary specialty

Medical Physician AssistantTaxonomy code 363AM0700X

Practice address

34800 Bob Wilson Dr
Military Health Clinic Building 6
San Diego, CA 92134-1098

Phone

(619) 532-8422

NPI assigned

Mar 23, 2011

Sex

Female

Sole proprietor

No

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

Enrolled in CA

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

Specialty

Physician Assistant

Education

Other, 2010

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Southbay Urgent Care IncGroup PAC ID 6406166339, 3 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

Practice roles

Locations

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.

• Southbay Urgent Care Inc

  • Urgent Care Clinic/Center
  • San Diego, CA
  • NPI 1558746750
  Medicare reassignment Care Compare group
• North Carolina Em-1 Medical Services, PC

  • Physician Assistant
  • Elizabethtown, NC
  • NPI 1306130695
  NPD
• Dr Carneiro Wound Medicine Corp

  • Primary Care Clinic/Center
  • San Diego, CA
  • NPI 1942983473
  NPD (past)
• Waterway Emergency Physicians LLC

  • Emergency Medicine Physician
  • Elizabeth City, NC
  • NPI 1487804670
  NPD (past)

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

{
    "created_epoch": "1300838400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1621209600000",
    "number": "1659670198",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "34800 BOB WILSON DR",
            "address_2": "MILITARY HEALTH CLINIC BUILDING 6",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921341098",
            "telephone_number": "619-532-8422"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "34800 BOB WILSON DR",
            "address_2": "MILITARY HEALTH CLINIC BUILDING 6",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921341098",
            "telephone_number": "619-532-8422"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CONLEY",
        "first_name": "KIMBERLY",
        "middle_name": "RENEE",
        "name_prefix": "Mrs.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-03-23",
        "last_updated": "2021-05-17",
        "certification_date": "2021-05-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kathryn Isabel Conklin, M.A., MFT
• Gwen Conlee, BCAT
• Tina Conlee, PHARM.D.
• Alison Marie Conley
• Caitlyn Audrey Conley, ASW
• Natasha Siddiqui Conley, D.O.
• Wendy Conley, PT
• Emily Conlon, LMFT
• Conn Chiropractic Inc.
• Bart Anthony Conn, D.C.

• Medical Physician Assistant in San Diego, CA
• Providers in San Diego, CA by specialty
• Medical Physician Assistant in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 17, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.