Individual provider Active NPI

Jody J Conley, DC

  • Chiropractor
  • East Lansing, MI
National Provider Identifier
1710080395
Registry record updated Mar 22, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
2301007165 Issued in MI
Practice address
4500 S Hagadorn
East Lansing, MI 48823
Phone
(517) 324-5433
Fax
(517) 324-9594
NPI assigned
Sep 7, 2006
Last updated
Mar 22, 2011By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 22, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 2301007165 MI Primary

Addresses

Primary practice location

4500 S Hagadorn
East Lansing, MI 48823

Mailing address

4500 S Hagadorn
East Lansing, MI 48823
Phone (517) 324-5433

Other identifiers 3

IdentifierTypeStateIssuer
4571071MedicaidMI
950C350680OtherMIBCBS
1009992OtherMIMCLAREN

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040412000180 MI Practitioner - Chiropractic 6002800331 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Logan College of Chiropractic, 1995
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Infinity Chiropractic Center P L L CGroup PAC ID 5395737050, 2 clinicians

Practice addresses (Care Compare)

4500 S Hagadorn Rd
East Lansing, MI 48823-6813
Phone (517) 324-5433

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Infinity Chiropractic Center P L L C Chiropractor CurrentSince Jan 1, 2004 Accepting new patients

Locations

4500 S Hagadorn Rd
East Lansing, MI 48823
Phone (517) 324-5433

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, 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": "1157587200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1300752000000",
    "number": "1710080395",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4500 S HAGADORN",
            "city": "EAST LANSING",
            "state": "MI",
            "postal_code": "48823",
            "telephone_number": "517-324-5433",
            "fax_number": "517-324-9594"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4500 S HAGADORN",
            "city": "EAST LANSING",
            "state": "MI",
            "postal_code": "48823",
            "telephone_number": "517-324-5433",
            "fax_number": "517-324-9594"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CONLEY",
        "first_name": "JODY",
        "middle_name": "J",
        "credential": "DC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-07",
        "last_updated": "2011-03-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "MI",
            "license": "2301007165",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4571071",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "950C350680",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MCLAREN",
            "identifier": "1009992",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in East Lansing, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 22, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • 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.