Individual provider Active NPI

Gary Elizabeth Conly, DNP, FNP

  • Family Nurse Practitioner
  • Charleston, SC
National Provider Identifier
1679162085
Registry record updated Mar 7, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
24463 Issued in SC
Practice address
25 Courtenay Drive
Charleston, SC 29425
Phone
(843) 792-2300
NPI assigned
Jan 12, 2021
Last updated
Mar 7, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 7, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 24463 SC
Family Nurse Practitioner 363LF0000X 24463 SC Primary

Addresses

Primary practice location

25 Courtenay Drive
Charleston, SC 29425

Mailing address

PO Box 751461
Charlotte, NC 28275-1461
Phone (843) 792-2300

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address direct@direct.musc.edu Health Information Exchange (HIE)

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in SC
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
I20210830001756 SC Practitioner - Nurse Practitioner 0244635225 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
79.02 of 100Reported as group
Quality
62.41
Promoting interoperability
99
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
24463SCMDPediatric Nephrology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
University Medical Associates of the Medical University of South Carol CurrentSince Aug 12, 2021 Accepting new patients
University Medical Associates of the Medical University of South Carol Nurse Practitioner CurrentSince Aug 12, 2021 Accepting new patients

Locations

171 Ashley Ave
Charleston, SC 29425
Phone (843) 792-2123

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": "1610409600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1646611200000",
    "number": "1679162085",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 751461",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282751461",
            "telephone_number": "843-792-2300"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "25 COURTENAY DRIVE",
            "city": "CHARLESTON",
            "state": "SC",
            "postal_code": "29425",
            "telephone_number": "843-792-2300"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CONLY",
        "first_name": "GARY",
        "middle_name": "ELIZABETH",
        "credential": "DNP, FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-01-12",
        "last_updated": "2022-03-07",
        "certification_date": "2022-03-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "SC",
            "license": "24463",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "SC",
            "license": "24463",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "direct@direct.musc.edu",
            "affiliation": "N",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "address_1": "25 Courtenay Drive",
            "city": "Charleston",
            "state": "SC",
            "country_code": "US",
            "postal_code": "29425",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Charleston, SC

Sources for this page

Verify at the official NPI Registry.