Active NPI
Lawrence Christopher Conover, PAC
- Physician Assistant
- Medford, OR
National Provider Identifier
1689938656
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- PA172028
- Practice address
- 1698 E McAndrews Rd Ste 400
Medford, OR 97504-5590 - Phone
- (541) 732-6000
- Fax
- (541) 732-6005
- NPI assigned
- Jun 25, 2012
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | PA10003269 | WA | |
| Physician Assistant | 363A00000X | PA172028 | OR | Primary |
Addresses
Primary practice location
1698 E McAndrews Rd Ste 400
Medford, OR 97504-5590
Mailing address
PO Box 3158
Portland, OR 97208-3158
Phone (541) 732-6000
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PA172028 | OR | MD | Physician Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1340582400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1435190400000",
"number": "1689938656",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 3158",
"city": "PORTLAND",
"state": "OR",
"postal_code": "972083158",
"telephone_number": "541-732-6000",
"fax_number": "541-732-6005"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1698 E MCANDREWS RD STE 400",
"city": "MEDFORD",
"state": "OR",
"postal_code": "975045590",
"telephone_number": "541-732-6000",
"fax_number": "541-732-6005"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CONOVER",
"first_name": "LAWRENCE",
"middle_name": "CHRISTOPHER",
"name_prefix": "Mr.",
"credential": "PAC",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2012-06-25",
"last_updated": "2015-06-25",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "WA",
"license": "PA10003269",
"primary": false
},
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "OR",
"license": "PA172028",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Medford, OR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 25, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.