Julie Conyers MD Inc

Primary specialty

Surgery PhysicianTaxonomy code 208600000X

License

G89174 Issued in CA

Legal business name

JULIE CONYERS MD INC

Practice address

635 Lassen LN
Mount Shasta, CA 96067-9003

Phone

(530) 926-5211

Fax

(530) 926-5740

NPI assigned

Aug 6, 2012

Organization subpart

No

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

Authorized official

Name

Dr. Julie A Conyers, MD

Title

President

Phone

(530) 926-5211

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1344211200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1352073600000",
    "number": "1730436007",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "635 LASSEN LN",
            "city": "MOUNT SHASTA",
            "state": "CA",
            "postal_code": "960679003",
            "telephone_number": "530-926-5211",
            "fax_number": "530-926-5740"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "635 LASSEN LN",
            "city": "MOUNT SHASTA",
            "state": "CA",
            "postal_code": "960679003",
            "telephone_number": "530-926-5211",
            "fax_number": "530-926-5740"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JULIE CONYERS MD INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-08-06",
        "last_updated": "2012-11-05",
        "status": "A",
        "authorized_official_last_name": "CONYERS",
        "authorized_official_first_name": "JULIE",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "530-926-5211",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Surgery",
            "state": "CA",
            "license": "G89174",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Surgery Physician in Mount Shasta, CA
• Providers in Mount Shasta, CA by specialty
• Surgery Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 5, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.