Individual provider Active NPI

Elizabeth T Conley, PA

  • Physician Assistant
  • Lexington, KY
National Provider Identifier
1760650261
Registry record updated Jun 10, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA930 Issued in KY
Practice address
740 S Limestone Ste J107
Lexington, KY 40536-2701
Phone
(859) 323-5603
Fax
(859) 323-3704
NPI assigned
Feb 19, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 10, 2025

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X PA930 KY
Surgical Physician Assistant 363AS0400X PA930 KY
Physician Assistant 363A00000X PA930 KY Primary

Addresses

Primary practice location

740 S Limestone Ste J107
Lexington, KY 40536-2701

Mailing address

1221 S Broadway
Lexington, KY 40504-2701
Phone (859) 258-6360

Other practice location 1

1207 S Broadway
Lexington, KY 40504-2701
Phone (859) 258-4800

Other identifiers 1

IdentifierTypeStateIssuer
7100153680MedicaidKY

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KY
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
I20110207000099 KY Practitioner - Physician Assistant 3971783135 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
PA930KYMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
University of Kentucky CurrentSince Jul 1, 2025 Accepting new patients
University of Kentucky PastSince Jun 15, 2025 Accepting new patients
Kentucky Medical Services Foundation, Inc PastSince Jun 15, 2025 Accepting new patients

Locations

800 Rose St
Lexington, KY 40536
Phone (859) 257-8562

1740 Nicholasville Rd
Lexington, KY 40503
Phone (859) 260-6100

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1203379200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1749513600000",
    "number": "1760650261",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1221 S BROADWAY",
            "city": "LEXINGTON",
            "state": "KY",
            "postal_code": "405042701",
            "telephone_number": "859-258-6360",
            "fax_number": "859-276-2392"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "740 S LIMESTONE STE J107",
            "city": "LEXINGTON",
            "state": "KY",
            "postal_code": "405362701",
            "telephone_number": "859-323-5603",
            "fax_number": "859-323-3704"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1207 S Broadway",
            "address_purpose": "LOCATION",
            "city": "Lexington",
            "state": "KY",
            "postal_code": "405042701",
            "country_code": "US",
            "telephone_number": "859-258-4800",
            "fax_number": "859-258-4740",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CONLEY",
        "first_name": "ELIZABETH",
        "middle_name": "T",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-02-19",
        "last_updated": "2025-06-10",
        "certification_date": "2025-06-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "KY",
            "license": "PA930",
            "primary": false
        },
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "KY",
            "license": "PA930",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "KY",
            "license": "PA930",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7100153680",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Lexington, KY

Sources for this page

Verify at the official NPI Registry.