Individual provider Active NPI

Conner Lanier, PA

  • Physician Assistant
  • Nampa, ID
National Provider Identifier
1801635974
Registry record updated Jan 9, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
3071299 Issued in ID
Practice address
1115 12TH Ave Rd
Nampa, ID 83686-5738
Phone
(208) 498-1080
Fax
(208) 498-1081
NPI assigned
May 20, 2024
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 9, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 3071299 ID Primary

Addresses

Primary practice location

1115 12TH Ave Rd
Nampa, ID 83686-5738

Mailing address

PO Box 191050
Boise, ID 83719-1050
Phone (208) 955-6500

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in ID
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
I20260120003544 ID Practitioner - Physician Assistant 6305323411 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2025
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Alliance Medical Group LLCGroup PAC ID 3971544685, 132 clinicians

Practice addresses (Care Compare)

1115 12TH Ave Rd
Nampa, ID 83686-5738
Phone (208) 498-1080

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
3071299IDMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Alliance Medical Group, LLC Family Medicine CurrentSince Feb 2, 2026 Accepting new patients
Alliance Medical Group, LLC Family Medicine CurrentSince Feb 2, 2026 Accepting new patients

Locations

10482 W Carlton Bay Dr
Garden City, ID 83714
Phone (208) 454-9690

1115 12th Ave Rd
Nampa, ID 83686
Phone (208) 498-1080

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1716163200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1767916800000",
    "number": "1801635974",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 191050",
            "city": "BOISE",
            "state": "ID",
            "postal_code": "837191050",
            "telephone_number": "208-955-6500",
            "fax_number": "208-955-6501"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1115 12TH AVE RD",
            "city": "NAMPA",
            "state": "ID",
            "postal_code": "836865738",
            "telephone_number": "208-498-1080",
            "fax_number": "208-498-1081"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LANIER",
        "first_name": "CONNER",
        "credential": "PA",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2024-05-20",
        "last_updated": "2026-01-09",
        "certification_date": "2026-01-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "ID",
            "license": "3071299",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Nampa, ID

Sources for this page

Verify at the official NPI Registry.